17D2268331 CLIA NUMBER - DAMM PHARMACY

Laboratory Demographics

CLIA Number: 17D2268331

Facility Name: DAMM PHARMACY

Facility Address:
201 N BALTIMORE
DERBY, KS
ZIP 67037
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Facility Phone Number: 316 788-5533

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1568579316

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	17D2268331
LAB Type	Pharmacy
Facility Name	DAMM PHARMACY
Street	201 N BALTIMORE
City	DERBY
State	KS
ZIP	67037
Phone	316 788-5533
CertificateType	4
CertificateEffectiveDate	9/9/2022
CertificateExpirationDate	9/8/2024
FacilityType	Waiver

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