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13D1036462 CLIA NUMBER - SAV-ON PHARMACY #0193

Laboratory Demographics

CLIA Number: 13D1036462

Facility Name: SAV-ON PHARMACY #0193

Facility Address:
1653 S VISTA AVE
BOISE, ID
ZIP 83705
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Facility Phone Number: 208 331-3007

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1255379491

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 13D1036462
LAB Type Pharmacy
Facility Name SAV-ON PHARMACY #0193
Street 1653 S VISTA AVE
City BOISE
State ID
ZIP 83705
Phone 208 331-3007
CertificateType 4
CertificateEffectiveDate 2/4/2023
CertificateExpirationDate 2/3/2025
FacilityType Waiver

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