25D2184405 CLIA NUMBER - MOORE'S PHARMACY

Laboratory Demographics

CLIA Number: 25D2184405

Facility Name: MOORE'S PHARMACY

Facility Address:
16831 HWY 21
SEBASTOPOL, MS
ZIP 39359
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Facility Phone Number: 601 625-7158

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376633818

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	25D2184405
LAB Type	Pharmacy
Facility Name	MOORE'S PHARMACY
Street	16831 HWY 21
City	SEBASTOPOL
State	MS
ZIP	39359
Phone	601 625-7158
CertificateType	4
CertificateEffectiveDate	5/19/2022
CertificateExpirationDate	5/18/2024
FacilityType	Waiver

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