10D2209334 CLIA NUMBER - VISTACARE PHARMACY I

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Laboratory Demographics

CLIA Number: 10D2209334

Facility Name: VISTACARE PHARMACY I

Facility Address:
1441 E FLETCHER AVE STE 113
TAMPA, FL
ZIP 33612
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Facility Phone Number: 813 444-4410

Facility Type: Mobile Laboratory

Certificate Type: Waiver

NPI Number: 1245622117

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	10D2209334
LAB Type	Mobile Laboratory
Facility Name	VISTACARE PHARMACY I
Street	1441 E FLETCHER AVE STE 113
City	TAMPA
State	FL
ZIP	33612
Phone	813 444-4410
CertificateType	4
CertificateEffectiveDate	1/13/2023
CertificateExpirationDate	1/12/2025
FacilityType	Waiver

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