23D2205831 CLIA NUMBER - ONECARE LTC LLC

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Laboratory Demographics

CLIA Number: 23D2205831

Facility Name: ONECARE LTC LLC

Facility Address:
1945 HEIDE DRIVE
TROY, MI
ZIP 48084
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Facility Phone Number: 248 663-2273

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1013394378

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	23D2205831
LAB Type	Pharmacy
Facility Name	ONECARE LTC LLC
Street	1945 HEIDE DRIVE
City	TROY
State	MI
ZIP	48084
Phone	248 663-2273
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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