05D2268279 CLIA NUMBER - SUNRISE PHARMACY

Laboratory Demographics

CLIA Number: 05D2268279

Facility Name: SUNRISE PHARMACY

Facility Address:
51 WELLNESS WAY #110
VALLEY SPRINGS, CA
ZIP 95252
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Facility Phone Number: 209 584-9088

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1851925671

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	05D2268279
LAB Type	Pharmacy
Facility Name	SUNRISE PHARMACY
Street	51 WELLNESS WAY #110
City	VALLEY SPRINGS
State	CA
ZIP	95252
Phone	209 584-9088
CertificateType	4
CertificateEffectiveDate	9/8/2022
CertificateExpirationDate	9/7/2024
FacilityType	Waiver

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