37D2071111 CLIA NUMBER - HOMELAND PHARMACY #495

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Laboratory Demographics

CLIA Number: 37D2071111

Facility Name: HOMELAND PHARMACY #495

Facility Address:
310 W TRUDGEON
HENRYETTA, OK
ZIP 74437
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Facility Phone Number: 918 652-2553

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1033234125

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	37D2071111
LAB Type	Pharmacy
Facility Name	HOMELAND PHARMACY #495
Street	310 W TRUDGEON
City	HENRYETTA
State	OK
ZIP	74437
Phone	918 652-2553
CertificateType	4
CertificateEffectiveDate	1/2/2024
CertificateExpirationDate	1/1/2026
FacilityType	Waiver

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