34D2100744 CLIA NUMBER - HARRIS TEETER #091 PHARMACY ATTN PHARMACIST IN CHARGE

Laboratory Demographics

CLIA Number: 34D2100744

Facility Name: HARRIS TEETER #091 PHARMACY ATTN PHARMACIST IN CHARGE

Facility Address:
401 PISGAH CHURCH ROAD
GREENSBORO, NC
ZIP 27455
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Facility Phone Number: 336 286-9433

Facility Type: Other - RETAIL PHARMACY

Certificate Type: Waiver

NPI Number: 1043312077

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	34D2100744
LAB Type	Other - RETAIL PHARMACY
Facility Name	HARRIS TEETER #091 PHARMACY ATTN PHARMACIST IN CHARGE
Street	401 PISGAH CHURCH ROAD
City	GREENSBORO
State	NC
ZIP	27455
Phone	336 286-9433
CertificateType	4
CertificateEffectiveDate	8/21/2023
CertificateExpirationDate	8/20/2025
FacilityType	Waiver

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