24D1048706 CLIA NUMBER - THRIFTY WHITE PHARMACY #023

Laboratory Demographics

CLIA Number: 24D1048706

Facility Name: THRIFTY WHITE PHARMACY #023

Facility Address:
321 HWY 10 WEST
DETROIT LAKES, MN
ZIP 56501
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Facility Phone Number: 218 847-9248

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326137928

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	24D1048706
LAB Type	Pharmacy
Facility Name	THRIFTY WHITE PHARMACY #023
Street	321 HWY 10 WEST
City	DETROIT LAKES
State	MN
ZIP	56501
Phone	218 847-9248
CertificateType	4
CertificateEffectiveDate	2/11/2023
CertificateExpirationDate	2/10/2025
FacilityType	Waiver

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