14D2066267 CLIA NUMBER - MEIJER PHARMACY #269 (DBA) MEIJER GREAT LAKES LIMITED PARTNERSHIP

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Laboratory Demographics

CLIA Number: 14D2066267

Facility Name: MEIJER PHARMACY #269 (DBA) MEIJER GREAT LAKES LIMITED PARTNERSHIP

Facility Address:
3649 N VERMILLION ST
DANVILLE, IL
ZIP 61832
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Facility Phone Number: 217 655-7210

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134556277

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	14D2066267
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #269 (DBA) MEIJER GREAT LAKES LIMITED PARTNERSHIP
Street	3649 N VERMILLION ST
City	DANVILLE
State	IL
ZIP	61832
Phone	217 655-7210
CertificateType	4
CertificateEffectiveDate	9/24/2023
CertificateExpirationDate	9/23/2025
FacilityType	Waiver

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