05D2269069 CLIA NUMBER - ROYAL OAK PHARMACY

Laboratory Demographics

CLIA Number: 05D2269069

Facility Name: ROYAL OAK PHARMACY

Facility Address:
812 5TH STREET
MARYSVILLE, CA
ZIP 95901
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Facility Phone Number: 530 743-4629

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417522475

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	05D2269069
LAB Type	Pharmacy
Facility Name	ROYAL OAK PHARMACY
Street	812 5TH STREET
City	MARYSVILLE
State	CA
ZIP	95901
Phone	530 743-4629
CertificateType	4
CertificateEffectiveDate	9/20/2022
CertificateExpirationDate	9/19/2024
FacilityType	Waiver

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