34D2121654 CLIA NUMBER - SEVEN LAKES PRESCRIPTION SHOPPE

Laboratory Demographics

CLIA Number: 34D2121654

Facility Name: SEVEN LAKES PRESCRIPTION SHOPPE

Facility Address:
120 MACDOUGALL DRIVE
WEST END, NC
ZIP 27376
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Facility Phone Number: 910 673-7467

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831721364

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	34D2121654
LAB Type	Pharmacy
Facility Name	SEVEN LAKES PRESCRIPTION SHOPPE
Street	120 MACDOUGALL DRIVE
City	WEST END
State	NC
ZIP	27376
Phone	910 673-7467
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

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