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07D2122612 CLIA NUMBER - STOP & SHOP PHARMACY #689

Laboratory Demographics

CLIA Number: 07D2122612

Facility Name: STOP & SHOP PHARMACY #689

Facility Address:
286 BROAD ST
MANCHESTER, CT
ZIP 06040
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Facility Phone Number: 860 647-0325

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1407888373

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 07D2122612
LAB Type Pharmacy
Facility Name STOP & SHOP PHARMACY #689
Street 286 BROAD ST
City MANCHESTER
State CT
ZIP 06040
Phone 860 647-0325
CertificateType 4
CertificateEffectiveDate 12/1/2022
CertificateExpirationDate 11/30/2024
FacilityType Waiver

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