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25D0030383 CLIA NUMBER - LONGEST STUDENT HEALTH CENTER LAB MISSISSIPPI STATE UNIVERSITY

Laboratory Demographics

CLIA Number: 25D0030383

Facility Name: LONGEST STUDENT HEALTH CENTER LAB MISSISSIPPI STATE UNIVERSITY

Facility Address:
360 HARDY ROAD
MISSISSIPPI STATE, MS
ZIP 39762
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Facility Phone Number: 662 325-7541

Facility Type: School/Student Health Service

Certificate Type: Certificate of Compliance
NPI Number: 1659357978

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 25D0030383
LAB Type School/Student Health Service
Facility Name LONGEST STUDENT HEALTH CENTER LAB MISSISSIPPI STATE UNIVERSITY
Street 360 HARDY ROAD
City MISSISSIPPI STATE
State MS
ZIP 39762
Phone 662 325-7541
CertificateType 2
CertificateEffectiveDate 6/1/2022
CertificateExpirationDate 5/31/2024
FacilityType Compliance

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