13D2150047 CLIA NUMBER - MEDICAL CLINIC PHARMACY

Laboratory Demographics

CLIA Number: 13D2150047

Facility Name: MEDICAL CLINIC PHARMACY

Facility Address:
315 E ELM ST STE 150
CALDWELL, ID
ZIP 83605
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Facility Phone Number: (208) 459-1503

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1962581652

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	13D2150047
LAB Type	PHARMACY
Facility Name	MEDICAL CLINIC PHARMACY
Street	315 E ELM ST STE 150
City	CALDWELL
State	ID
ZIP	83605
Phone	(208) 459-1503

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