10D2269667 CLIA NUMBER - ELITE CARE PHARMACY

Laboratory Demographics

CLIA Number: 10D2269667

Facility Name: ELITE CARE PHARMACY

Facility Address:
3680 N WICKHAM RD STE C
MELBOURNE, FL
ZIP 32935
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Facility Phone Number: 321 608-4949

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699443895

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	10D2269667
LAB Type	Pharmacy
Facility Name	ELITE CARE PHARMACY
Street	3680 N WICKHAM RD STE C
City	MELBOURNE
State	FL
ZIP	32935
Phone	321 608-4949
CertificateType	4
CertificateEffectiveDate	9/30/2022
CertificateExpirationDate	9/29/2024
FacilityType	Waiver

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