18D2235170 CLIA NUMBER - MIDWAY PHARMACY OF CLARKSON INC

Laboratory Demographics

CLIA Number: 18D2235170

Facility Name: MIDWAY PHARMACY OF CLARKSON INC

Facility Address:
408 EAST MAPLE STREET
CANEYVILLE, KY
ZIP 42721
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Facility Phone Number: 270 879-6355

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1467439083

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	18D2235170
LAB Type	Pharmacy
Facility Name	MIDWAY PHARMACY OF CLARKSON INC
Street	408 EAST MAPLE STREET
City	CANEYVILLE
State	KY
ZIP	42721
Phone	270 879-6355
CertificateType	4
CertificateEffectiveDate	9/7/2023
CertificateExpirationDate	9/6/2025
FacilityType	Waiver

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