14D2072918 CLIA NUMBER - HUDSON DRUG SHOP

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Laboratory Demographics

CLIA Number: 14D2072918

Facility Name: HUDSON DRUG SHOP

Facility Address:
108 N MARKET
PAXTON, IL
ZIP 60957
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Facility Phone Number: 217 379-4858

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1639223084

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	14D2072918
LAB Type	Pharmacy
Facility Name	HUDSON DRUG SHOP
Street	108 N MARKET
City	PAXTON
State	IL
ZIP	60957
Phone	217 379-4858
CertificateType	4
CertificateEffectiveDate	2/7/2024
CertificateExpirationDate	2/6/2026
FacilityType	Waiver

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