16D2290019 CLIA NUMBER - MEDICAP PHARMACY

Laboratory Demographics

CLIA Number: 16D2290019

Facility Name: MEDICAP PHARMACY

Facility Address:
400 N ELM ST
JEFFERSON, IA
ZIP 50129
Get Directions

Facility Phone Number: 641 231-1488

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1639173685

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	16D2290019
LAB Type	Pharmacy
Facility Name	MEDICAP PHARMACY
Street	400 N ELM ST
City	JEFFERSON
State	IA
ZIP	50129
Phone	641 231-1488
CertificateType	4
CertificateEffectiveDate	9/19/2023
CertificateExpirationDate	9/18/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

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

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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