23D2219470 CLIA NUMBER - WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #11245

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Laboratory Demographics

CLIA Number: 23D2219470

Facility Name: WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #11245

Facility Address:
8900 MACOMB
GROSSE ILE, MI
ZIP 48138
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Facility Phone Number: 401 770-6431

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1174631543

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	23D2219470
LAB Type	Pharmacy
Facility Name	WOODWARD DETROIT CVS LLC DBA CVS/PHARMACY #11245
Street	8900 MACOMB
City	GROSSE ILE
State	MI
ZIP	48138
Phone	401 770-6431
CertificateType	4
CertificateEffectiveDate	4/6/2023
CertificateExpirationDate	4/5/2025
FacilityType	Waiver

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