49D2187276 CLIA NUMBER - GIANT PHARMACY #788

Laboratory Demographics

CLIA Number: 49D2187276

Facility Name: GIANT PHARMACY #788

Facility Address:
14125 ST GERMAIN DRIVE
CENTREVILLE, VA
ZIP 20121
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Facility Phone Number: 703 631-7720

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003849340

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	49D2187276
LAB Type	Pharmacy
Facility Name	GIANT PHARMACY #788
Street	14125 ST GERMAIN DRIVE
City	CENTREVILLE
State	VA
ZIP	20121
Phone	703 631-7720
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