13D2076333 CLIA NUMBER - RIDLEY'S PHARMACY #7156

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Laboratory Demographics

CLIA Number: 13D2076333

Facility Name: RIDLEY'S PHARMACY #7156

Facility Address:
1000 POCATELLO CREEK RD
POCATELLO, ID
ZIP 83201
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Facility Phone Number: (208) 233-4051

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1184050148

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	13D2076333
LAB Type	PHARMACY
Facility Name	RIDLEY'S PHARMACY #7156
Street	1000 POCATELLO CREEK RD
City	POCATELLO
State	ID
ZIP	83201
Phone	(208) 233-4051

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This page was last updated on: 5/11/2023