42D2156770 CLIA NUMBER - HARRIS TEETER PHARMACY #97-0420

Laboratory Demographics

CLIA Number: 42D2156770

Facility Name: HARRIS TEETER PHARMACY #97-0420

Facility Address:
1720 AUGUSTA STREET
GREENVILLE, SC
ZIP 29605
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Facility Phone Number: 864 977-8045

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1063914372

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	42D2156770
LAB Type	Pharmacy
Facility Name	HARRIS TEETER PHARMACY #97-0420
Street	1720 AUGUSTA STREET
City	GREENVILLE
State	SC
ZIP	29605
Phone	864 977-8045
CertificateType	4
CertificateEffectiveDate	10/24/2022
CertificateExpirationDate	10/23/2024
FacilityType	Waiver

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