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13D2126016 CLIA NUMBER - RITE AID PHARMACY #6779

Laboratory Demographics

CLIA Number: 13D2126016

Facility Name: RITE AID PHARMACY #6779

Facility Address:
3250 S EAGLE RD
MERIDIAN, ID
ZIP 83642
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Facility Phone Number: 208 898-2543

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1265982920

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 13D2126016
LAB Type Pharmacy
Facility Name RITE AID PHARMACY #6779
Street 3250 S EAGLE RD
City MERIDIAN
State ID
ZIP 83642
Phone 208 898-2543
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