10D2169243 CLIA NUMBER - COSTCO PHARMACY #1364

Laboratory Demographics

CLIA Number: 10D2169243

Facility Name: COSTCO PHARMACY #1364

Facility Address:
805 LIGHTHOUSE DR
BRADENTON, FL
ZIP 34212
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Facility Phone Number: (425) 313-6275

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1134789639

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	10D2169243
LAB Type	PHARMACY
Facility Name	COSTCO PHARMACY #1364
Street	805 LIGHTHOUSE DR
City	BRADENTON
State	FL
ZIP	34212
Phone	(425) 313-6275

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This page was last updated on: 5/11/2023