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51D1005636 CLIA NUMBER - FRUTH PHARMACY 10

Laboratory Demographics

CLIA Number: 51D1005636

Facility Name: FRUTH PHARMACY 10

Facility Address:
3109 TEAYS VALLEY ROAD
HURRICANE, WV
ZIP 25526
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Facility Phone Number: 304 562-2677

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1437164373

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 51D1005636
LAB Type Pharmacy
Facility Name FRUTH PHARMACY 10
Street 3109 TEAYS VALLEY ROAD
City HURRICANE
State WV
ZIP 25526
Phone 304 562-2677
CertificateType 4
CertificateEffectiveDate 10/28/2022
CertificateExpirationDate 10/27/2024
FacilityType Waiver

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