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36D0034062 CLIA NUMBER - HENDERSON PHARM SERV INC DBA MED SHOP #749

Laboratory Demographics

CLIA Number: 36D0034062

Facility Name: HENDERSON PHARM SERV INC DBA MED SHOP #749

Facility Address:
186 W MAIN ST
CHILLICOTHE, OH
ZIP 45601
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Facility Phone Number: 614 775-1181

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1962570945

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 36D0034062
LAB Type Pharmacy
Facility Name HENDERSON PHARM SERV INC DBA MED SHOP #749
Street 186 W MAIN ST
City CHILLICOTHE
State OH
ZIP 45601
Phone 614 775-1181
CertificateType 4
CertificateEffectiveDate 9/1/2022
CertificateExpirationDate 8/31/2024
FacilityType Waiver

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