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23D2186365 CLIA NUMBER - RITE AID #4498

Laboratory Demographics

CLIA Number: 23D2186365

Facility Name: RITE AID #4498

Facility Address:
13939 LIVERNOIS AVENUE
DETROIT, MI
ZIP 48238
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Facility Phone Number: 313 934-0150

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1992814453

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 23D2186365
LAB Type Pharmacy
Facility Name RITE AID #4498
Street 13939 LIVERNOIS AVENUE
City DETROIT
State MI
ZIP 48238
Phone 313 934-0150
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