05D2189797 CLIA NUMBER - SELMA PHARMACY

Laboratory Demographics

CLIA Number: 05D2189797

Facility Name: SELMA PHARMACY

Facility Address:
2132 HIGH ST
SELMA, CA
ZIP 93662
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Facility Phone Number: 817 500-7020

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1750937447

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	05D2189797
LAB Type	Pharmacy
Facility Name	SELMA PHARMACY
Street	2132 HIGH ST
City	SELMA
State	CA
ZIP	93662
Phone	817 500-7020
CertificateType	4
CertificateEffectiveDate	8/5/2022
CertificateExpirationDate	8/4/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024