14D2020165 CLIA NUMBER - KINGSWAY PHARMACY

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Laboratory Demographics

CLIA Number: 14D2020165

Facility Name: KINGSWAY PHARMACY

Facility Address:
1677 MONTGOMERY RD
AURORA, IL
ZIP 60504
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Facility Phone Number: 630 236-9502

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1639232390

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	14D2020165
LAB Type	Pharmacy
Facility Name	KINGSWAY PHARMACY
Street	1677 MONTGOMERY RD
City	AURORA
State	IL
ZIP	60504
Phone	630 236-9502
CertificateType	4
CertificateEffectiveDate	2/14/2023
CertificateExpirationDate	2/13/2025
FacilityType	Waiver

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