46D1035966 CLIA NUMBER - MACEYS PHARMACY #1

Laboratory Demographics

CLIA Number: 46D1035966

Facility Name: MACEYS PHARMACY #1

Facility Address:
880 N STATE STREET
OREM, UT
ZIP 84057
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Facility Phone Number: 801 225-4621

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1548379753

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	46D1035966
LAB Type	Pharmacy
Facility Name	MACEYS PHARMACY #1
Street	880 N STATE STREET
City	OREM
State	UT
ZIP	84057
Phone	801 225-4621
CertificateType	4
CertificateEffectiveDate	1/18/2023
CertificateExpirationDate	1/17/2025
FacilityType	Waiver

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