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50D2221044 CLIA NUMBER - CVS/PHARMACY #16776

Laboratory Demographics

CLIA Number: 50D2221044

Facility Name: CVS/PHARMACY #16776

Facility Address:
16200 SE MILL PLAIN BLVD
VANCOUVER, WA
ZIP 98684
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Facility Phone Number: 360 449-6425

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1578585261

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 50D2221044
LAB Type Pharmacy
Facility Name CVS/PHARMACY #16776
Street 16200 SE MILL PLAIN BLVD
City VANCOUVER
State WA
ZIP 98684
Phone 360 449-6425
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