15D1008265 CLIA NUMBER - MEIJER PHARMACY #141

Laboratory Demographics

CLIA Number: 15D1008265

Facility Name: MEIJER PHARMACY #141

Facility Address:
2301 E MARKLAND AVE
KOKOMO, IN
ZIP 46901
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Facility Phone Number: 765 454-7810

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1891065603

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	15D1008265
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #141
Street	2301 E MARKLAND AVE
City	KOKOMO
State	IN
ZIP	46901
Phone	765 454-7810
CertificateType	4
CertificateEffectiveDate	1/15/2023
CertificateExpirationDate	1/14/2025
FacilityType	Waiver

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