23D2084265 CLIA NUMBER - VG'S PHARMACY #1930

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Laboratory Demographics

CLIA Number: 23D2084265

Facility Name: VG'S PHARMACY #1930

Facility Address:
8503 DAVISON ROAD
DAVISON, MI
ZIP 48423
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Facility Phone Number: 810 658-9710

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053556753

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	23D2084265
LAB Type	Pharmacy
Facility Name	VG'S PHARMACY #1930
Street	8503 DAVISON ROAD
City	DAVISON
State	MI
ZIP	48423
Phone	810 658-9710
CertificateType	4
CertificateEffectiveDate	9/22/2022
CertificateExpirationDate	9/21/2024
FacilityType	Waiver

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