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13D2126011 CLIA NUMBER - RITE AID PHARMACY #5408

Laboratory Demographics

CLIA Number: 13D2126011

Facility Name: RITE AID PHARMACY #5408

Facility Address:
1904 19TH AVENUE
LEWISTON, ID
ZIP 83501
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Facility Phone Number: 208 743-9127

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1982626891

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 13D2126011
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #5408
Street 1904 19TH AVENUE
City LEWISTON
State ID
ZIP 83501
Phone 208 743-9127
CertificateType 4
CertificateEffectiveDate 2/17/2023
CertificateExpirationDate 2/16/2025
FacilityType Waiver

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