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13D1036468 CLIA NUMBER - SAV-ON PHARMACY #0254

Laboratory Demographics

CLIA Number: 13D1036468

Facility Name: SAV-ON PHARMACY #0254

Facility Address:
161 W PRAIRIE AVE
HAYDEN, ID
ZIP 83835
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Facility Phone Number: 208 772-7864

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1194771600

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 13D1036468
LAB Type Pharmacy
Facility Name SAV-ON PHARMACY #0254
Street 161 W PRAIRIE AVE
City HAYDEN
State ID
ZIP 83835
Phone 208 772-7864
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