23D2186251 CLIA NUMBER - RITE AID #4407

Laboratory Demographics

CLIA Number: 23D2186251

Facility Name: RITE AID #4407

Facility Address:
1243 US 31 SOUTH
MANISTEE, MI
ZIP 49660
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Facility Phone Number: 231 723-9438

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1477662930

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	23D2186251
LAB Type	Pharmacy
Facility Name	RITE AID #4407
Street	1243 US 31 SOUTH
City	MANISTEE
State	MI
ZIP	49660
Phone	231 723-9438
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