24D1099454 CLIA NUMBER - COBORN'S PHARMACY #2016

Laboratory Demographics

CLIA Number: 24D1099454

Facility Name: COBORN'S PHARMACY #2016

Facility Address:
645 LAKE ST S
LONG PRAIRIE, MN
ZIP 56347
Get Directions

Facility Phone Number: 320 534-2745

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902480650

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	24D1099454
LAB Type	Pharmacy
Facility Name	COBORN'S PHARMACY #2016
Street	645 LAKE ST S
City	LONG PRAIRIE
State	MN
ZIP	56347
Phone	320 534-2745
CertificateType	4
CertificateEffectiveDate	10/15/2023
CertificateExpirationDate	10/14/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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