34D2212070 CLIA NUMBER - TABOR CITY MEDICINE MART

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Laboratory Demographics

CLIA Number: 34D2212070

Facility Name: TABOR CITY MEDICINE MART

Facility Address:
220 SOUTH MAIN STREET
TABOR CITY, NC
ZIP 28463
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Facility Phone Number: 910 653-4800

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1912013889

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	34D2212070
LAB Type	Pharmacy
Facility Name	TABOR CITY MEDICINE MART
Street	220 SOUTH MAIN STREET
City	TABOR CITY
State	NC
ZIP	28463
Phone	910 653-4800
CertificateType	4
CertificateEffectiveDate	2/2/2023
CertificateExpirationDate	2/1/2025
FacilityType	Waiver

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