37D2246702 CLIA NUMBER - CDL CENTRAL DRUG, INC

Laboratory Demographics

CLIA Number: 37D2246702

Facility Name: CDL CENTRAL DRUG, INC

Facility Address:
1220 W 12TH AVE
STILLWATER, OK
ZIP 74074
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Facility Phone Number: 405 372-6120

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902313604

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	37D2246702
LAB Type	Pharmacy
Facility Name	CDL CENTRAL DRUG, INC
Street	1220 W 12TH AVE
City	STILLWATER
State	OK
ZIP	74074
Phone	405 372-6120
CertificateType	4
CertificateEffectiveDate	12/29/2023
CertificateExpirationDate	12/28/2025
FacilityType	Waiver

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