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28D1058020 CLIA NUMBER - WEST HOLT MEMORIAL HOSPITAL DBA WEST HOLT PHARMACY

Laboratory Demographics

CLIA Number: 28D1058020

Facility Name: WEST HOLT MEMORIAL HOSPITAL DBA WEST HOLT PHARMACY

Facility Address:
313 W PEARL STREET
ATKINSON, NE
ZIP 68713
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Facility Phone Number: 402 925-2651

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1649716143

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 28D1058020
LAB Type Pharmacy
Facility Name WEST HOLT MEMORIAL HOSPITAL DBA WEST HOLT PHARMACY
Street 313 W PEARL STREET
City ATKINSON
State NE
ZIP 68713
Phone 402 925-2651
CertificateType 4
CertificateEffectiveDate 8/28/2022
CertificateExpirationDate 8/27/2024
FacilityType Waiver

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