34D2140875 CLIA NUMBER - HARRIS TEETER PHARMACY #422

Laboratory Demographics

CLIA Number: 34D2140875

Facility Name: HARRIS TEETER PHARMACY #422

Facility Address:
120 ALBANS ST, SUITE 100
RALEIGH, NC
ZIP 27609
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Facility Phone Number: 919 781-4165

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1609323203

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	34D2140875
LAB Type	Pharmacy
Facility Name	HARRIS TEETER PHARMACY #422
Street	120 ALBANS ST, SUITE 100
City	RALEIGH
State	NC
ZIP	27609
Phone	919 781-4165
CertificateType	4
CertificateEffectiveDate	12/4/2023
CertificateExpirationDate	12/3/2025
FacilityType	Waiver

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