21D2155491 CLIA NUMBER - HARRIS TEETER PHARMACY #97-0325

Laboratory Demographics

CLIA Number: 21D2155491

Facility Name: HARRIS TEETER PHARMACY #97-0325

Facility Address:
14101 DARNESTOWN ROAD
GERMANTOWN, MD
ZIP 20874
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Facility Phone Number: 240 631-9629

Facility Type: Other - PHARMACY

Certificate Type: Waiver

NPI Number: 1669555058

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	21D2155491
LAB Type	Other - PHARMACY
Facility Name	HARRIS TEETER PHARMACY #97-0325
Street	14101 DARNESTOWN ROAD
City	GERMANTOWN
State	MD
ZIP	20874
Phone	240 631-9629
CertificateType	4
CertificateEffectiveDate	10/1/2022
CertificateExpirationDate	9/30/2024
FacilityType	Waiver

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