27D2262295 CLIA NUMBER - MONTANA CVS PHARMACY, LLC DBA CVS/PHARMACY #08618

Laboratory Demographics

CLIA Number: 27D2262295

Facility Name: MONTANA CVS PHARMACY, LLC DBA CVS/PHARMACY #08618

Facility Address:
1300 E PARK AVE
ANACONDA, MT
ZIP 59711
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Facility Phone Number: 406 563-5266

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1356382253

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	27D2262295
LAB Type	Pharmacy
Facility Name	MONTANA CVS PHARMACY, LLC DBA CVS/PHARMACY #08618
Street	1300 E PARK AVE
City	ANACONDA
State	MT
ZIP	59711
Phone	406 563-5266
CertificateType	4
CertificateEffectiveDate	6/13/2022
CertificateExpirationDate	6/12/2024
FacilityType	Waiver

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