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11D2270719 CLIA NUMBER - THE MEDICINE CABINET WAYCROSS - DOWNTOWN

Laboratory Demographics

CLIA Number: 11D2270719

Facility Name: THE MEDICINE CABINET WAYCROSS - DOWNTOWN

Facility Address:
620 TEBEAU STREET
WAYCROSS, GA
ZIP 31501
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Facility Phone Number: 912 283-2772

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1861457004

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 11D2270719
LAB Type Pharmacy
Facility Name THE MEDICINE CABINET WAYCROSS - DOWNTOWN
Street 620 TEBEAU STREET
City WAYCROSS
State GA
ZIP 31501
Phone 912 283-2772
CertificateType 4
CertificateEffectiveDate 10/20/2022
CertificateExpirationDate 10/19/2024
FacilityType Waiver

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