36D2184166 CLIA NUMBER - PCA CORRECTIONS, LLC DBA SYNCHRONY COLUMBUS PHARMACY

Laboratory Demographics

CLIA Number: 36D2184166

Facility Name: PCA CORRECTIONS, LLC DBA SYNCHRONY COLUMBUS PHARMACY

Facility Address:
4014 VENTURE COURT
COLUMBUS, OH
ZIP 43228
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Facility Phone Number: 614 297-8244

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1750392312

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	36D2184166
LAB Type	Pharmacy
Facility Name	PCA CORRECTIONS, LLC DBA SYNCHRONY COLUMBUS PHARMACY
Street	4014 VENTURE COURT
City	COLUMBUS
State	OH
ZIP	43228
Phone	614 297-8244
CertificateType	4
CertificateEffectiveDate	5/15/2022
CertificateExpirationDate	5/14/2024
FacilityType	Waiver

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