44D2151971 CLIA NUMBER - TRITENN LLC DBA GRAY PHARMACY

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Laboratory Demographics

CLIA Number: 44D2151971

Facility Name: TRITENN LLC DBA GRAY PHARMACY

Facility Address:
208 SUNCREST DRIVE
GRAY, TN
ZIP 37615
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Facility Phone Number: 423 477-3847

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1194812446

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	44D2151971
LAB Type	Pharmacy
Facility Name	TRITENN LLC DBA GRAY PHARMACY
Street	208 SUNCREST DRIVE
City	GRAY
State	TN
ZIP	37615
Phone	423 477-3847
CertificateType	4
CertificateEffectiveDate	7/31/2022
CertificateExpirationDate	7/30/2024
FacilityType	Waiver

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