11D2184893 CLIA NUMBER - CHANCY DRUGS MOULTIRE

Laboratory Demographics

CLIA Number: 11D2184893

Facility Name: CHANCY DRUGS MOULTIRE

Facility Address:
101 NORTH MAIN STREET
MOULTRIE, GA
ZIP 31768
Get Directions

Facility Phone Number: 229 985-6725

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801931555

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	11D2184893
LAB Type	Pharmacy
Facility Name	CHANCY DRUGS MOULTIRE
Street	101 NORTH MAIN STREET
City	MOULTRIE
State	GA
ZIP	31768
Phone	229 985-6725
CertificateType	4
CertificateEffectiveDate	5/27/2022
CertificateExpirationDate	5/26/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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