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14D2177242 CLIA NUMBER - MEIJER PHARMACY #313

Laboratory Demographics

CLIA Number: 14D2177242

Facility Name: MEIJER PHARMACY #313

Facility Address:
541 PURI PARKWAY
SYCAMORE, IL
ZIP 60178
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Facility Phone Number: 815 991-1210

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1225669641

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 14D2177242
LAB Type Pharmacy
Facility Name MEIJER PHARMACY #313
Street 541 PURI PARKWAY
City SYCAMORE
State IL
ZIP 60178
Phone 815 991-1210
CertificateType 4
CertificateEffectiveDate 1/7/2024
CertificateExpirationDate 1/6/2026
FacilityType Waiver

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