49D0956712 CLIA NUMBER - GIANT PHARMACY #2745

Laboratory Demographics

CLIA Number: 49D0956712

Facility Name: GIANT PHARMACY #2745

Facility Address:
6364A SPRINGFIELD PLAZA
SPRINGFIELD, VA
ZIP 22150
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Facility Phone Number: 703 569-5401

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003849357

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	49D0956712
LAB Type	Pharmacy
Facility Name	GIANT PHARMACY #2745
Street	6364A SPRINGFIELD PLAZA
City	SPRINGFIELD
State	VA
ZIP	22150
Phone	703 569-5401
CertificateType	4
CertificateEffectiveDate	7/1/2022
CertificateExpirationDate	6/30/2024
FacilityType	Waiver

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