13D2092085 CLIA NUMBER - RITE AID PHARMACY #5418

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Laboratory Demographics

CLIA Number: 13D2092085

Facility Name: RITE AID PHARMACY #5418

Facility Address:
1100 VISTA AVE
BOISE, ID
ZIP 83705
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Facility Phone Number: 208 344-2529

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1437269321

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	13D2092085
LAB Type	Pharmacy
Facility Name	RITE AID PHARMACY #5418
Street	1100 VISTA AVE
City	BOISE
State	ID
ZIP	83705
Phone	208 344-2529
CertificateType	4
CertificateEffectiveDate	2/26/2023
CertificateExpirationDate	2/25/2025
FacilityType	Waiver

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