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47D2235434 CLIA NUMBER - KINNEY DRUGS #102

Laboratory Demographics

CLIA Number: 47D2235434

Facility Name: KINNEY DRUGS #102

Facility Address:
151 VERMONT ROUTE 12 SOUTH
RANDOLPH, VT
ZIP 05060
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Facility Phone Number: 802 728-6284

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1831417690

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 47D2235434
LAB Type Pharmacy
Facility Name KINNEY DRUGS #102
Street 151 VERMONT ROUTE 12 SOUTH
City RANDOLPH
State VT
ZIP 05060
Phone 802 728-6284
CertificateType 4
CertificateEffectiveDate 9/9/2023
CertificateExpirationDate 9/8/2025
FacilityType Waiver

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