18D2161488 CLIA NUMBER - UNIVERSITY OF LOUISVILLE HOSPITAL AMBULATORY CARE PHARMACY

Laboratory Demographics

CLIA Number: 18D2161488

Facility Name: UNIVERSITY OF LOUISVILLE HOSPITAL AMBULATORY CARE PHARMACY

Facility Address:
530 SOUTH JACKSON STREET
LOUISVILLE, KY
ZIP 40202
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Facility Phone Number: 502 562-3571

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1285272575

Taxonomy: 3336S0011X - Pharmacy
A pharmacy that dispenses generally low volume and high cost medicinal preparations to patients who are undergoing intensive therapies for illnesses that are generally chronic, complex and potentially life threatening. Often these therapies require specialized delivery and administration.

CLIA Record

Field Name	Field Value
CLIA Number	18D2161488
LAB Type	Pharmacy
Facility Name	UNIVERSITY OF LOUISVILLE HOSPITAL AMBULATORY CARE PHARMACY
Street	530 SOUTH JACKSON STREET
City	LOUISVILLE
State	KY
ZIP	40202
Phone	502 562-3571
CertificateType	4
CertificateEffectiveDate	2/5/2023
CertificateExpirationDate	2/4/2025
FacilityType	Waiver

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