23D2186240 CLIA NUMBER - RITE AID #4403

Laboratory Demographics

CLIA Number: 23D2186240

Facility Name: RITE AID #4403

Facility Address:
2580 LAKE AVENUE
NORTH MUSKEGON, MI
ZIP 49445
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Facility Phone Number: 231 744-8393

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1881617355

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	23D2186240
LAB Type	Pharmacy
Facility Name	RITE AID #4403
Street	2580 LAKE AVENUE
City	NORTH MUSKEGON
State	MI
ZIP	49445
Phone	231 744-8393
CertificateType	4
CertificateEffectiveDate	6/16/2022
CertificateExpirationDate	6/15/2024
FacilityType	Waiver

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