23D2193335 CLIA NUMBER - MI PHARM LLC DBA AMAC PHARMACY SERVICES

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Laboratory Demographics

CLIA Number: 23D2193335

Facility Name: MI PHARM LLC DBA AMAC PHARMACY SERVICES

Facility Address:
15115 FARMINGTON ROAD
LIVONIA, MI
ZIP 48154
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Facility Phone Number: 734 744-4070

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1649463712

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	23D2193335
LAB Type	Pharmacy
Facility Name	MI PHARM LLC DBA AMAC PHARMACY SERVICES
Street	15115 FARMINGTON ROAD
City	LIVONIA
State	MI
ZIP	48154
Phone	734 744-4070
CertificateType	4
CertificateEffectiveDate	9/21/2022
CertificateExpirationDate	9/20/2024
FacilityType	Waiver

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