17D2154029 CLIA NUMBER - SCOTT CITY EYE CENTER

Laboratory Demographics

CLIA Number: 17D2154029

Facility Name: SCOTT CITY EYE CENTER

Facility Address:
104 ALBERT AVE
SCOTT CITY, KS
ZIP 67871
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Facility Phone Number: 620 872-0040

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1639277833

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name	Field Value
CLIA Number	17D2154029
LAB Type	Physician Office
Facility Name	SCOTT CITY EYE CENTER
Street	104 ALBERT AVE
City	SCOTT CITY
State	KS
ZIP	67871
Phone	620 872-0040
CertificateType	4
CertificateEffectiveDate	9/5/2022
CertificateExpirationDate	9/4/2024
FacilityType	Waiver

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