22D2197858 CLIA NUMBER - SPRINGFIELD PHARMACY

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Laboratory Demographics

CLIA Number: 22D2197858

Facility Name: SPRINGFIELD PHARMACY

Facility Address:
2547 MAIN STREET SUITE 105
SPRINGFIELD, MA
ZIP 01107
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Facility Phone Number: 413 266-3462

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1316556012

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	22D2197858
LAB Type	Pharmacy
Facility Name	SPRINGFIELD PHARMACY
Street	2547 MAIN STREET SUITE 105
City	SPRINGFIELD
State	MA
ZIP	01107
Phone	413 266-3462
CertificateType	4
CertificateEffectiveDate	10/28/2022
CertificateExpirationDate	10/27/2024
FacilityType	Waiver

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