10D2134736 CLIA NUMBER - CYPRESS PHARMACY

Laboratory Demographics

CLIA Number: 10D2134736

Facility Name: CYPRESS PHARMACY

Facility Address:
9451 CYPRESS LAKE DRIVE
FORT MYERS, FL
ZIP 33919
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Facility Phone Number: 239 481-7322

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1487739215

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	10D2134736
LAB Type	Pharmacy
Facility Name	CYPRESS PHARMACY
Street	9451 CYPRESS LAKE DRIVE
City	FORT MYERS
State	FL
ZIP	33919
Phone	239 481-7322
CertificateType	4
CertificateEffectiveDate	8/8/2023
CertificateExpirationDate	8/7/2025
FacilityType	Waiver

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