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18D2186482 CLIA NUMBER - MAIN STREET PHARMACY

Laboratory Demographics

CLIA Number: 18D2186482

Facility Name: MAIN STREET PHARMACY

Facility Address:
289 MAIN STREET
CADIZ, KY
ZIP 42211
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Facility Phone Number: 270 882-2222

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1174090799

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 18D2186482
LAB Type Pharmacy
Facility Name MAIN STREET PHARMACY
Street 289 MAIN STREET
City CADIZ
State KY
ZIP 42211
Phone 270 882-2222
CertificateType 4
CertificateEffectiveDate 6/17/2022
CertificateExpirationDate 6/16/2024
FacilityType Waiver

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