10D2235877 CLIA NUMBER - LAKEN PHARMACY LLC

Laboratory Demographics

CLIA Number: 10D2235877

Facility Name: LAKEN PHARMACY LLC

Facility Address:
4352 W VINE ST STE 106
KISSIMMEE, FL
ZIP 34746
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Facility Phone Number: 407 479-0033

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1972172690

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	10D2235877
LAB Type	Pharmacy
Facility Name	LAKEN PHARMACY LLC
Street	4352 W VINE ST STE 106
City	KISSIMMEE
State	FL
ZIP	34746
Phone	407 479-0033
CertificateType	4
CertificateEffectiveDate	9/13/2023
CertificateExpirationDate	9/12/2025
FacilityType	Waiver

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