11D2108729 CLIA NUMBER - THE MEDICINE CABINET PHARMACY

Laboratory Demographics

CLIA Number: 11D2108729

Facility Name: THE MEDICINE CABINET PHARMACY

Facility Address:
722 SHIRLEY AVE
DOUGLAS, GA
ZIP 31533
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Facility Phone Number: 912 383-8510

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629418793

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	11D2108729
LAB Type	Pharmacy
Facility Name	THE MEDICINE CABINET PHARMACY
Street	722 SHIRLEY AVE
City	DOUGLAS
State	GA
ZIP	31533
Phone	912 383-8510
CertificateType	4
CertificateEffectiveDate	2/10/2024
CertificateExpirationDate	2/9/2026
FacilityType	Waiver

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