23D2186409 CLIA NUMBER - RITE AID #4520

Laboratory Demographics

CLIA Number: 23D2186409

Facility Name: RITE AID #4520

Facility Address:
5650 SCHAEFER ROAD
DEARBORN, MI
ZIP 48126
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Facility Phone Number: 313 581-3280

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760498067

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	23D2186409
LAB Type	Pharmacy
Facility Name	RITE AID #4520
Street	5650 SCHAEFER ROAD
City	DEARBORN
State	MI
ZIP	48126
Phone	313 581-3280
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