51D2235919 CLIA NUMBER - HTRX, LLC DBA HOMETOWN RX PHARMACY

Laboratory Demographics

CLIA Number: 51D2235919

Facility Name: HTRX, LLC DBA HOMETOWN RX PHARMACY

Facility Address:
369 HANGING ROCK HWY
LOGAN, WV
ZIP 25601
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Facility Phone Number: 304 752-0082

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1831863448

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	51D2235919
LAB Type	Pharmacy
Facility Name	HTRX, LLC DBA HOMETOWN RX PHARMACY
Street	369 HANGING ROCK HWY
City	LOGAN
State	WV
ZIP	25601
Phone	304 752-0082
CertificateType	4
CertificateEffectiveDate	9/14/2023
CertificateExpirationDate	9/13/2025
FacilityType	Waiver

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