23D2186364 CLIA NUMBER - RITE AID #4399

Laboratory Demographics

CLIA Number: 23D2186364

Facility Name: RITE AID #4399

Facility Address:
5520 DRAKE ROAD
WEST BLOOMFIELD, MI
ZIP 48322
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Facility Phone Number: 248 661-0774

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1124137682

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	23D2186364
LAB Type	Pharmacy
Facility Name	RITE AID #4399
Street	5520 DRAKE ROAD
City	WEST BLOOMFIELD
State	MI
ZIP	48322
Phone	248 661-0774
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