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53D1045556 CLIA NUMBER - OSCO PHARMACY #0065

Laboratory Demographics

CLIA Number: 53D1045556

Facility Name: OSCO PHARMACY #0065

Facility Address:
3355 E PERSHING BLVD
CHEYENNE, WY
ZIP 82001
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Facility Phone Number: 307 635-1155

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043494545

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 53D1045556
LAB Type Pharmacy
Facility Name OSCO PHARMACY #0065
Street 3355 E PERSHING BLVD
City CHEYENNE
State WY
ZIP 82001
Phone 307 635-1155
CertificateType 4
CertificateEffectiveDate 9/16/2023
CertificateExpirationDate 9/15/2025
FacilityType Waiver

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