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50D2221020 CLIA NUMBER - CVS/PHARMACY #16153

Laboratory Demographics

CLIA Number: 50D2221020

Facility Name: CVS/PHARMACY #16153

Facility Address:
2925 HARRISON AVE NW
OLYMPIA, WA
ZIP 98502
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Facility Phone Number: 360 570-4617

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1740202431

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 50D2221020
LAB Type Pharmacy
Facility Name CVS/PHARMACY #16153
Street 2925 HARRISON AVE NW
City OLYMPIA
State WA
ZIP 98502
Phone 360 570-4617
CertificateType 4
CertificateEffectiveDate 4/16/2021
CertificateExpirationDate 4/4/2028
FacilityType Waiver

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