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36D1077989 CLIA NUMBER - DISCOUNT DRUG MART #29

Laboratory Demographics

CLIA Number: 36D1077989

Facility Name: DISCOUNT DRUG MART #29

Facility Address:
4208 LIBERTY AVENUE
VERMILION, OH
ZIP 44089
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Facility Phone Number: 440 967-3000

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1740225663

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 36D1077989
LAB Type Pharmacy
Facility Name DISCOUNT DRUG MART #29
Street 4208 LIBERTY AVENUE
City VERMILION
State OH
ZIP 44089
Phone 440 967-3000
CertificateType 4
CertificateEffectiveDate 12/24/2023
CertificateExpirationDate 12/23/2025
FacilityType Waiver

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