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49D2149167 CLIA NUMBER - HARRIS TEETER PHARMACY #463

Laboratory Demographics

CLIA Number: 49D2149167

Facility Name: HARRIS TEETER PHARMACY #463

Facility Address:
3575 BRIDGE RD
SUFFOLK, VA
ZIP 23435
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Facility Phone Number: 757 947-0236

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1528565900

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 49D2149167
LAB Type Pharmacy
Facility Name HARRIS TEETER PHARMACY #463
Street 3575 BRIDGE RD
City SUFFOLK
State VA
ZIP 23435
Phone 757 947-0236
CertificateType 4
CertificateEffectiveDate 5/25/2022
CertificateExpirationDate 5/24/2024
FacilityType Waiver

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