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49D2187237 CLIA NUMBER - GIANT PHARMACY #740

Laboratory Demographics

CLIA Number: 49D2187237

Facility Name: GIANT PHARMACY #740

Facility Address:
5615 STONE ROAD
CENTREVILLE, VA
ZIP 20120
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Facility Phone Number: 703 803-8556

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1467485706

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 49D2187237
LAB Type Pharmacy
Facility Name GIANT PHARMACY #740
Street 5615 STONE ROAD
City CENTREVILLE
State VA
ZIP 20120
Phone 703 803-8556
CertificateType 4
CertificateEffectiveDate 6/29/2022
CertificateExpirationDate 6/28/2024
FacilityType Waiver

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