50D2186651 CLIA NUMBER - RITE AID PHARMACY #05236

Laboratory Demographics

CLIA Number: 50D2186651

Facility Name: RITE AID PHARMACY #05236

Facility Address:
1400 CORNWALL AVE
HAMILTON, WA
ZIP 98255
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Facility Phone Number: 360 733-1980

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1689785818

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	50D2186651
LAB Type	Pharmacy
Facility Name	RITE AID PHARMACY #05236
Street	1400 CORNWALL AVE
City	HAMILTON
State	WA
ZIP	98255
Phone	360 733-1980
CertificateType	4
CertificateEffectiveDate	6/19/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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