37D2236956 CLIA NUMBER - REAVIS DRUG

Laboratory Demographics

CLIA Number: 37D2236956

Facility Name: REAVIS DRUG

Facility Address:
110 BURR AVE
PAULS VALLEY, OK
ZIP 73075
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Facility Phone Number: 405 238-7391

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1699772806

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	37D2236956
LAB Type	Pharmacy
Facility Name	REAVIS DRUG
Street	110 BURR AVE
City	PAULS VALLEY
State	OK
ZIP	73075
Phone	405 238-7391
CertificateType	4
CertificateEffectiveDate	9/21/2023
CertificateExpirationDate	9/20/2025
FacilityType	Waiver

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