23D2186125 CLIA NUMBER - RITE AID #3520

Laboratory Demographics

CLIA Number: 23D2186125

Facility Name: RITE AID #3520

Facility Address:
11 EAST DIVISION STREET
SPARTA, MI
ZIP 49345
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Facility Phone Number: 616 887-0600

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1184634792

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	23D2186125
LAB Type	Pharmacy
Facility Name	RITE AID #3520
Street	11 EAST DIVISION STREET
City	SPARTA
State	MI
ZIP	49345
Phone	616 887-0600
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