23D1008415 CLIA NUMBER - MEIJER PHARMACY #63

Laboratory Demographics

CLIA Number: 23D1008415

Facility Name: MEIJER PHARMACY #63

Facility Address:
30800 LITTLE MACK ROAD
ROSEVILLE, MI
ZIP 48066
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Facility Phone Number: 586 415-6164

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831239334

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	23D1008415
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #63
Street	30800 LITTLE MACK ROAD
City	ROSEVILLE
State	MI
ZIP	48066
Phone	586 415-6164
CertificateType	4
CertificateEffectiveDate	1/21/2023
CertificateExpirationDate	1/20/2025
FacilityType	Waiver

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