12D2196477 CLIA NUMBER - 5 MINUTE PHARMACY LTC LLC

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Laboratory Demographics

CLIA Number: 12D2196477

Facility Name: 5 MINUTE PHARMACY LTC LLC

Facility Address:
94-449 AKOKI ST SUITE 102
WAIPAHU, HI
ZIP 96797
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Facility Phone Number: 808 671-5511

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1104573088

Taxonomy: 3336S0011X - Pharmacy
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

CLIA Record

Field Name	Field Value
CLIA Number	12D2196477
LAB Type	Pharmacy
Facility Name	5 MINUTE PHARMACY LTC LLC
Street	94-449 AKOKI ST SUITE 102
City	WAIPAHU
State	HI
ZIP	96797
Phone	808 671-5511
CertificateType	4
CertificateEffectiveDate	10/16/2022
CertificateExpirationDate	10/15/2024
FacilityType	Waiver

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