23D2186088 CLIA NUMBER - RITE AID #1521

Laboratory Demographics

CLIA Number: 23D2186088

Facility Name: RITE AID #1521

Facility Address:
2130 WEALTHY ST SE
GRAND RAPIDS, MI
ZIP 49506
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Facility Phone Number: 616 451-0711

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1811910722

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	23D2186088
LAB Type	Pharmacy
Facility Name	RITE AID #1521
Street	2130 WEALTHY ST SE
City	GRAND RAPIDS
State	MI
ZIP	49506
Phone	616 451-0711
CertificateType	4
CertificateEffectiveDate	6/15/2022
CertificateExpirationDate	6/14/2024
FacilityType	Waiver

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