25D2182522 CLIA NUMBER - GATLIN'S PHARMACY

Laboratory Demographics

CLIA Number: 25D2182522

Facility Name: GATLIN'S PHARMACY

Facility Address:
18 1ST AVE
TISHOMINGO, MS
ZIP 38873
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Facility Phone Number: 662 438-6605

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1518058288

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	25D2182522
LAB Type	Pharmacy
Facility Name	GATLIN'S PHARMACY
Street	18 1ST AVE
City	TISHOMINGO
State	MS
ZIP	38873
Phone	662 438-6605
CertificateType	4
CertificateEffectiveDate	4/22/2024
CertificateExpirationDate	4/21/2026
FacilityType	Waiver

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