50D2186834 CLIA NUMBER - RITE AID PHARMACY #05189

Laboratory Demographics

CLIA Number: 50D2186834

Facility Name: RITE AID PHARMACY #05189

Facility Address:
20518 108TH AVE SE
KENT, WA
ZIP 98031
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Facility Phone Number: 253 854-2999

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1538173562

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	50D2186834
LAB Type	Pharmacy
Facility Name	RITE AID PHARMACY #05189
Street	20518 108TH AVE SE
City	KENT
State	WA
ZIP	98031
Phone	253 854-2999
CertificateType	4
CertificateEffectiveDate	6/22/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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