35D1076243 CLIA NUMBER - CHURCHILL PHARMACY INC

Laboratory Demographics

CLIA Number: 35D1076243

Facility Name: CHURCHILL PHARMACY INC

Facility Address:
1190 W TURNPIKE AVE
BISMARCK, ND
ZIP 58501
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Facility Phone Number: 701 224-0339

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710056452

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	35D1076243
LAB Type	Pharmacy
Facility Name	CHURCHILL PHARMACY INC
Street	1190 W TURNPIKE AVE
City	BISMARCK
State	ND
ZIP	58501
Phone	701 224-0339
CertificateType	4
CertificateEffectiveDate	11/8/2023
CertificateExpirationDate	11/7/2025
FacilityType	Waiver

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