23D0949637 CLIA NUMBER - MEIJER PHARMACY #50

Laboratory Demographics

CLIA Number: 23D0949637

Facility Name: MEIJER PHARMACY #50

Facility Address:
5531 28TH STREET SE
GRAND RAPIDS, MI
ZIP 49512
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Facility Phone Number: 616 949-0772

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1578603031

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	23D0949637
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #50
Street	5531 28TH STREET SE
City	GRAND RAPIDS
State	MI
ZIP	49512
Phone	616 949-0772
CertificateType	4
CertificateEffectiveDate	8/6/2022
CertificateExpirationDate	8/5/2024
FacilityType	Waiver

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