23D2186402 CLIA NUMBER - RITE AID #4506

Laboratory Demographics

CLIA Number: 23D2186402

Facility Name: RITE AID #4506

Facility Address:
720 SOUTH MITCHELL STREET
CADILLAC, MI
ZIP 49601
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Facility Phone Number: 231 775-3423

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1508975020

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	23D2186402
LAB Type	Pharmacy
Facility Name	RITE AID #4506
Street	720 SOUTH MITCHELL STREET
City	CADILLAC
State	MI
ZIP	49601
Phone	231 775-3423
CertificateType	4
CertificateEffectiveDate	6/17/2022
CertificateExpirationDate	6/16/2024
FacilityType	Waiver

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