49D2117442 CLIA NUMBER - CAVALIER PHARMACY

Laboratory Demographics

CLIA Number: 49D2117442

Facility Name: CAVALIER PHARMACY

Facility Address:
301 CHURCH STREET
WISE, VA
ZIP 24293
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Facility Phone Number: 276 328-9141

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1568487387

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	49D2117442
LAB Type	Pharmacy
Facility Name	CAVALIER PHARMACY
Street	301 CHURCH STREET
City	WISE
State	VA
ZIP	24293
Phone	276 328-9141
CertificateType	4
CertificateEffectiveDate	8/16/2022
CertificateExpirationDate	8/15/2024
FacilityType	Waiver

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