16D0699487 CLIA NUMBER - OSTERHAUS PHARMACY

Laboratory Demographics

CLIA Number: 16D0699487

Facility Name: OSTERHAUS PHARMACY

Facility Address:
918 W PLATT STREET, SUITE 2
MAQUOKETA, IA
ZIP 52060
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Facility Phone Number: 563 652-5611

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1861155699

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	16D0699487
LAB Type	Pharmacy
Facility Name	OSTERHAUS PHARMACY
Street	918 W PLATT STREET, SUITE 2
City	MAQUOKETA
State	IA
ZIP	52060
Phone	563 652-5611
CertificateType	4
CertificateEffectiveDate	9/1/2022
CertificateExpirationDate	8/31/2024
FacilityType	Waiver

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