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10D2186042 CLIA NUMBER - SIMPLYWELL SPECIALTY PHARMACY LLC

Laboratory Demographics

CLIA Number: 10D2186042

Facility Name: SIMPLYWELL SPECIALTY PHARMACY LLC

Facility Address:
463128 STATE RPAD 200
YULEE, FL
ZIP 32097
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Facility Phone Number: 904 468-3020

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1619458981

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 10D2186042
LAB Type Pharmacy
Facility Name SIMPLYWELL SPECIALTY PHARMACY LLC
Street 463128 STATE RPAD 200
City YULEE
State FL
ZIP 32097
Phone 904 468-3020
CertificateType 4
CertificateEffectiveDate 6/12/2022
CertificateExpirationDate 6/11/2024
FacilityType Waiver

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