15D0966745 CLIA NUMBER - MEIJER PHARMACY #137

Laboratory Demographics

CLIA Number: 15D0966745

Facility Name: MEIJER PHARMACY #137

Facility Address:
4901 SR 26 E
LAFAYETTE, IN
ZIP 47905
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Facility Phone Number: 765 449-9210

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710257514

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	15D0966745
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #137
Street	4901 SR 26 E
City	LAFAYETTE
State	IN
ZIP	47905
Phone	765 449-9210
CertificateType	4
CertificateEffectiveDate	10/25/2023
CertificateExpirationDate	10/24/2025
FacilityType	Waiver

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