23D2186275 CLIA NUMBER - RITE AID #4439

Laboratory Demographics

CLIA Number: 23D2186275

Facility Name: RITE AID #4439

Facility Address:
841 SOUTH STATE ROAD
DAVISON, MI
ZIP 48423
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Facility Phone Number: 810 653-7485

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134135437

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	23D2186275
LAB Type	Pharmacy
Facility Name	RITE AID #4439
Street	841 SOUTH STATE ROAD
City	DAVISON
State	MI
ZIP	48423
Phone	810 653-7485
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