45D2181465 CLIA NUMBER - GROCERY OUTLET PHARMACY

Laboratory Demographics

CLIA Number: 45D2181465

Facility Name: GROCERY OUTLET PHARMACY

Facility Address:
1568 AUSTIN HWY
SAN ANTONIO, TX
ZIP 78218
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Facility Phone Number: 210 446-2364

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1346781945

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	45D2181465
LAB Type	Pharmacy
Facility Name	GROCERY OUTLET PHARMACY
Street	1568 AUSTIN HWY
City	SAN ANTONIO
State	TX
ZIP	78218
Phone	210 446-2364
CertificateType	4
CertificateEffectiveDate	4/6/2024
CertificateExpirationDate	4/5/2026
FacilityType	Waiver

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