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15D2256877 CLIA NUMBER - HOOK-SUPERX, LLC DBA CVS/PHARMACY #06626

Laboratory Demographics

CLIA Number: 15D2256877

Facility Name: HOOK-SUPERX, LLC DBA CVS/PHARMACY #06626

Facility Address:
301 E MAIN ST
GAS CITY, IN
ZIP 46933
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Facility Phone Number: 866 389-2727

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1194828897

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 15D2256877
LAB Type Pharmacy
Facility Name HOOK-SUPERX, LLC DBA CVS/PHARMACY #06626
Street 301 E MAIN ST
City GAS CITY
State IN
ZIP 46933
Phone 866 389-2727
CertificateType 4
CertificateEffectiveDate 3/29/2024
CertificateExpirationDate 3/28/2026
FacilityType Waiver

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