26D2216657 CLIA NUMBER - GOOD GRACES PHARMACY

Laboratory Demographics

CLIA Number: 26D2216657

Facility Name: GOOD GRACES PHARMACY

Facility Address:
857 E MAIN STREET, SUITE 3
WILLOW SPRINGS, MO
ZIP 65793
Get Directions

Facility Phone Number: 417 855-1085

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1174273114

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	26D2216657
LAB Type	Pharmacy
Facility Name	GOOD GRACES PHARMACY
Street	857 E MAIN STREET, SUITE 3
City	WILLOW SPRINGS
State	MO
ZIP	65793
Phone	417 855-1085
CertificateType	4
CertificateEffectiveDate	3/15/2023
CertificateExpirationDate	3/14/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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