Healther Providers Data Logo

15D2283104 CLIA NUMBER - HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542

Laboratory Demographics

CLIA Number: 15D2283104

Facility Name: HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542

Facility Address:
4026 S 00 EW
KOKOMO, IN
ZIP 46902
Get Directions

Facility Phone Number: 765 453-3979

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1801999503

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 15D2283104
LAB Type Pharmacy
Facility Name HOOK-SUPERX, LLC DBA CVS/PHARMACY #06542
Street 4026 S 00 EW
City KOKOMO
State IN
ZIP 46902
Phone 765 453-3979
CertificateType 4
CertificateEffectiveDate 6/1/2023
CertificateExpirationDate 5/31/2025
FacilityType Waiver

Download Record

Download this CLIA NUMBER record in Text format: Export

Download this CLIA NUMBER record in Excel (CSV) format: Export

Download this CLIA NUMBER record in XML format: Export

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