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52D0875208 CLIA NUMBER - CORAM ALTERNATE SITE SERVICES DBA CORAM CVS/SPECIALTY INFUSION SERVICES

Laboratory Demographics

CLIA Number: 52D0875208

Facility Name: CORAM ALTERNATE SITE SERVICES DBA CORAM CVS/SPECIALTY INFUSION SERVICES

Facility Address:
5345 S MOORLAND RD STE 101
NEW BERLIN, WI
ZIP 53151
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Facility Phone Number: 262 207-1590

Facility Type: Home Health Agency

Certificate Type: Waiver
NPI Number: 1326095852

Taxonomy: 3336H0001X - Pharmacy
Pharmacy-based, decentralized patient care organization with expertise in USP 797-compliant sterile drug compounding that provides care to patients with acute or chronic conditions generally pertaining to parenteral administration of drugs, biologics and nutritional formulae administered through catheters and/or needles in home and alternate sites. Extensive professional pharmacy services, care coordination, infusion nursing services, supplies and equipment are provided to optimize efficacy and compliance.

CLIA Record

Field Name Field Value
CLIA Number 52D0875208
LAB Type Home Health Agency
Facility Name CORAM ALTERNATE SITE SERVICES DBA CORAM CVS/SPECIALTY INFUSION SERVICES
Street 5345 S MOORLAND RD STE 101
City NEW BERLIN
State WI
ZIP 53151
Phone 262 207-1590
CertificateType 4
CertificateEffectiveDate 8/19/2023
CertificateExpirationDate 8/18/2025
FacilityType Waiver

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