11D2185424 CLIA NUMBER - LO COST PHARMACY

Laboratory Demographics

CLIA Number: 11D2185424

Facility Name: LO COST PHARMACY

Facility Address:
612 E 69TH STREET
SAVANNAH, GA
ZIP 31410
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Facility Phone Number: 912 352-0375

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1487006961

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	11D2185424
LAB Type	Pharmacy
Facility Name	LO COST PHARMACY
Street	612 E 69TH STREET
City	SAVANNAH
State	GA
ZIP	31410
Phone	912 352-0375
CertificateType	4
CertificateEffectiveDate	6/3/2022
CertificateExpirationDate	6/2/2024
FacilityType	Waiver

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