17D2182350 CLIA NUMBER - SUN FRESH PHARMACY #41

Laboratory Demographics

CLIA Number: 17D2182350

Facility Name: SUN FRESH PHARMACY #41

Facility Address:
2803 S 47TH ST
KANSAS CITY, KS
ZIP 66106
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Facility Phone Number: 913 831-4140

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1275648370

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	17D2182350
LAB Type	Pharmacy
Facility Name	SUN FRESH PHARMACY #41
Street	2803 S 47TH ST
City	KANSAS CITY
State	KS
ZIP	66106
Phone	913 831-4140
CertificateType	4
CertificateEffectiveDate	4/20/2024
CertificateExpirationDate	4/19/2026
FacilityType	Waiver

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