49D2187031 CLIA NUMBER - SPENCER'S DRUGSTORE, INC

Laboratory Demographics

CLIA Number: 49D2187031

Facility Name: SPENCER'S DRUGSTORE, INC

Facility Address:
100 NORTH MAIN STREET
BLACKSTONE, VA
ZIP 23824
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Facility Phone Number: 434 292-3132

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235125360

Taxonomy: 332B00000X - Durable Medical Equipment & Medical Supplies
A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

CLIA Record

Field Name	Field Value
CLIA Number	49D2187031
LAB Type	Pharmacy
Facility Name	SPENCER'S DRUGSTORE, INC
Street	100 NORTH MAIN STREET
City	BLACKSTONE
State	VA
ZIP	23824
Phone	434 292-3132
CertificateType	4
CertificateEffectiveDate	6/24/2022
CertificateExpirationDate	6/23/2024
FacilityType	Waiver

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