02D2222118 CLIA NUMBER - ALASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #17404

Laboratory Demographics

CLIA Number: 02D2222118

Facility Name: ALASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #17404

Facility Address:
1801 E PARKS HIGHWAY
WASILLA, AK
ZIP 99654
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Facility Phone Number: 401 765-1500

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1841448743

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	02D2222118
LAB Type	Pharmacy
Facility Name	ALASKA CVS PHARMACY, LLC DBA CVS/PHARMACY #17404
Street	1801 E PARKS HIGHWAY
City	WASILLA
State	AK
ZIP	99654
Phone	401 765-1500
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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