24D2054824 CLIA NUMBER - THRIFTY WHITE PHARMACY #778

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Laboratory Demographics

CLIA Number: 24D2054824

Facility Name: THRIFTY WHITE PHARMACY #778

Facility Address:
321 NORTH JEFFERSON
WADENA, MN
ZIP 56482
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Facility Phone Number: 218 631-4050

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1457652497

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	24D2054824
LAB Type	Pharmacy
Facility Name	THRIFTY WHITE PHARMACY #778
Street	321 NORTH JEFFERSON
City	WADENA
State	MN
ZIP	56482
Phone	218 631-4050
CertificateType	4
CertificateEffectiveDate	2/28/2023
CertificateExpirationDate	2/27/2025
FacilityType	Waiver

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