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33D2262962 CLIA NUMBER - PORTVILLE FIRE DISTRICT NO 1

Laboratory Demographics

CLIA Number: 33D2262962

Facility Name: PORTVILLE FIRE DISTRICT NO 1

Facility Address:
25 S MAIN ST
PORTVILLE, NY
ZIP 14770
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Facility Phone Number: 716 933-6179

Facility Type: Ambulance

Certificate Type: Waiver
NPI Number: 1942348834

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name Field Value
CLIA Number 33D2262962
LAB Type Ambulance
Facility Name PORTVILLE FIRE DISTRICT NO 1
Street 25 S MAIN ST
City PORTVILLE
State NY
ZIP 14770
Phone 716 933-6179
CertificateType 4
CertificateEffectiveDate 6/21/2022
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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