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17D0961791 CLIA NUMBER - HEN HOUSE PHARMACY #33

Laboratory Demographics

CLIA Number: 17D0961791

Facility Name: HEN HOUSE PHARMACY #33

Facility Address:
6900 W 135TH ST
OVERLAND PARK, KS
ZIP 66210
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Facility Phone Number: 913 814-9355

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1992810097

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 17D0961791
LAB Type Pharmacy
Facility Name HEN HOUSE PHARMACY #33
Street 6900 W 135TH ST
City OVERLAND PARK
State KS
ZIP 66210
Phone 913 814-9355
CertificateType 4
CertificateEffectiveDate 6/17/2023
CertificateExpirationDate 6/16/2025
FacilityType Waiver

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