36D2161960 CLIA NUMBER - G L DAVIS DRUG

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Laboratory Demographics

CLIA Number: 36D2161960

Facility Name: G L DAVIS DRUG

Facility Address:
109 WEST ST
CALDWELL, OH
ZIP 43724
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Facility Phone Number: 740 732-4503

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1760580765

Taxonomy: 1835P1200X - Pharmacist
A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing pharmacotherapeutic care of patients, by developing, implementing, monitoring, and modifying complex treatment plans, providing advanced level education and consultation, and collaborating with other health professionals in the management of therapy.

CLIA Record

Field Name	Field Value
CLIA Number	36D2161960
LAB Type	Pharmacy
Facility Name	G L DAVIS DRUG
Street	109 WEST ST
City	CALDWELL
State	OH
ZIP	43724
Phone	740 732-4503
CertificateType	4
CertificateEffectiveDate	2/13/2023
CertificateExpirationDate	2/12/2025
FacilityType	Waiver

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