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15D2282843 CLIA NUMBER - HOOK-SUPERX LLC DBA CVS/PHARMACY #02941

Laboratory Demographics

CLIA Number: 15D2282843

Facility Name: HOOK-SUPERX LLC DBA CVS/PHARMACY #02941

Facility Address:
610 W MARKLAND AVE
KOKOMO, IN
ZIP 46901
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Facility Phone Number: 765 457-4407

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1508963091

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 15D2282843
LAB Type Pharmacy
Facility Name HOOK-SUPERX LLC DBA CVS/PHARMACY #02941
Street 610 W MARKLAND AVE
City KOKOMO
State IN
ZIP 46901
Phone 765 457-4407
CertificateType 4
CertificateEffectiveDate 5/26/2023
CertificateExpirationDate 5/25/2025
FacilityType Waiver

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