18D2183476 CLIA NUMBER - PCA CORRECTIONS, LLC DBA SYNCHRONY LOUISVILLE PHARMACY

Laboratory Demographics

CLIA Number: 18D2183476

Facility Name: PCA CORRECTIONS, LLC DBA SYNCHRONY LOUISVILLE PHARMACY

Facility Address:
2701 CHESTNUT STATION COURT
LOUISVILLE, KY
ZIP 40299
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Facility Phone Number: 502 266-2549

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1548231293

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	18D2183476
LAB Type	Physician Office
Facility Name	PCA CORRECTIONS, LLC DBA SYNCHRONY LOUISVILLE PHARMACY
Street	2701 CHESTNUT STATION COURT
City	LOUISVILLE
State	KY
ZIP	40299
Phone	502 266-2549
CertificateType	4
CertificateEffectiveDate	5/6/2024
CertificateExpirationDate	5/5/2026
FacilityType	Waiver

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