23D2186719 CLIA NUMBER - RITE AID #4579

Laboratory Demographics

CLIA Number: 23D2186719

Facility Name: RITE AID #4579

Facility Address:
1025 ASHMUN STREET
SAULT SAINTE MARIE, MI
ZIP 49783
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Facility Phone Number: 906 632-6874

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083723530

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	23D2186719
LAB Type	Pharmacy
Facility Name	RITE AID #4579
Street	1025 ASHMUN STREET
City	SAULT SAINTE MARIE
State	MI
ZIP	49783
Phone	906 632-6874
CertificateType	4
CertificateEffectiveDate	6/22/2022
CertificateExpirationDate	6/21/2024
FacilityType	Waiver

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