49D2156379 CLIA NUMBER - HARRIS TEETER PHARMACY #97-0307

Laboratory Demographics

CLIA Number: 49D2156379

Facility Name: HARRIS TEETER PHARMACY #97-0307

Facility Address:
301 WEST BROAD STREET
FALLS CHURCH, VA
ZIP 22046
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Facility Phone Number: 571 830-6832

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205281334

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	49D2156379
LAB Type	Pharmacy
Facility Name	HARRIS TEETER PHARMACY #97-0307
Street	301 WEST BROAD STREET
City	FALLS CHURCH
State	VA
ZIP	22046
Phone	571 830-6832
CertificateType	4
CertificateEffectiveDate	10/17/2022
CertificateExpirationDate	10/16/2024
FacilityType	Waiver

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