24D2193444 CLIA NUMBER - ALIXA RX LLC

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Laboratory Demographics

CLIA Number: 24D2193444

Facility Name: ALIXA RX LLC

Facility Address:
10132 WEST 76TH STREET
EDEN PRAIRIE, MN
ZIP 55344
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Facility Phone Number: 612 486-1900

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1497020390

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	24D2193444
LAB Type	Pharmacy
Facility Name	ALIXA RX LLC
Street	10132 WEST 76TH STREET
City	EDEN PRAIRIE
State	MN
ZIP	55344
Phone	612 486-1900
CertificateType	4
CertificateEffectiveDate	9/22/2022
CertificateExpirationDate	9/21/2024
FacilityType	Waiver

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