39D2292242 CLIA NUMBER - GIANT PHARMACY #6300

Laboratory Demographics

  • CLIA Code: 39D2292242
  • Facility Name: GIANT PHARMACY #6300
  • Facility Address: 3175 CAPE HORN ROAD
    RED LION, PA
    ZIP 17356
  • Facility Phone: 717 246-7478
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEANINE M. RUSNAK
  • NPI Number: 1174555197
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2292242
LAB Type Pharmacy
Facility Name GIANT PHARMACY #6300
Street 3175 CAPE HORN ROAD
City RED LION
State PA
ZIP 17356
Phone 717 246-7478
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/23/2025
Certificate Expiration Date 10/22/2027
Facility Type Pharmacy
Lab Director JEANINE M. RUSNAK

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This page was last updated on: 9/29/2025