23D2186103 CLIA NUMBER - RITE AID #1530

Laboratory Demographics

CLIA Number: 23D2186103

Facility Name: RITE AID #1530

Facility Address:
715 SOUTH CLINTON STREET
GRAND LEDGE, MI
ZIP 48837
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Facility Phone Number: 517 627-2800

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1215046750

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	23D2186103
LAB Type	Pharmacy
Facility Name	RITE AID #1530
Street	715 SOUTH CLINTON STREET
City	GRAND LEDGE
State	MI
ZIP	48837
Phone	517 627-2800
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