34D2261391 CLIA NUMBER - ROSE PHARMACY AND BOUTIQUE APOTHECARY

Laboratory Demographics

CLIA Number: 34D2261391

Facility Name: ROSE PHARMACY AND BOUTIQUE APOTHECARY

Facility Address:
20035 JETTON RD SUITE B
CORNELIUS, NC
ZIP 28031
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Facility Phone Number: 704 255-6172

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1942947460

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	34D2261391
LAB Type	Pharmacy
Facility Name	ROSE PHARMACY AND BOUTIQUE APOTHECARY
Street	20035 JETTON RD SUITE B
City	CORNELIUS
State	NC
ZIP	28031
Phone	704 255-6172
CertificateType	4
CertificateEffectiveDate	5/31/2022
CertificateExpirationDate	5/30/2024
FacilityType	Waiver

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