15D0976560 CLIA NUMBER - MEIJER PHARMACY 170

Laboratory Demographics

CLIA Number: 15D0976560

Facility Name: MEIJER PHARMACY 170

Facility Address:
10138 INDIANAPOLIS BLVD
HIGHLAND, IN
ZIP 46322
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Facility Phone Number: 219 934-2110

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1578834800

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	15D0976560
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY 170
Street	10138 INDIANAPOLIS BLVD
City	HIGHLAND
State	IN
ZIP	46322
Phone	219 934-2110
CertificateType	4
CertificateEffectiveDate	8/8/2022
CertificateExpirationDate	8/7/2024
FacilityType	Waiver

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