15D0928836 CLIA NUMBER - SALEM APOTHECARY INC

Laboratory Demographics

CLIA Number: 15D0928836

Facility Name: SALEM APOTHECARY INC

Facility Address:
3 PUBLIC SQ
SALEM, IN
ZIP 47167
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Facility Phone Number: 812 883-4500

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1114984473

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	15D0928836
LAB Type	Pharmacy
Facility Name	SALEM APOTHECARY INC
Street	3 PUBLIC SQ
City	SALEM
State	IN
ZIP	47167
Phone	812 883-4500
CertificateType	4
CertificateEffectiveDate	5/28/2023
CertificateExpirationDate	5/27/2025
FacilityType	Waiver

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