23D2074357 CLIA NUMBER - MEIJER PHARMACY #271

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Laboratory Demographics

CLIA Number: 23D2074357

Facility Name: MEIJER PHARMACY #271

Facility Address:
1223 PHOENIX STREET
SOUTH HAVEN, MI
ZIP 49090
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Facility Phone Number: 269 639-3510

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1881010205

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	23D2074357
LAB Type	Pharmacy
Facility Name	MEIJER PHARMACY #271
Street	1223 PHOENIX STREET
City	SOUTH HAVEN
State	MI
ZIP	49090
Phone	269 639-3510
CertificateType	4
CertificateEffectiveDate	3/6/2024
CertificateExpirationDate	3/5/2026
FacilityType	Waiver

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