50D2246399 CLIA NUMBER - SQUARE CARE MEDICAL & PHARMACY

Laboratory Demographics

CLIA Number: 50D2246399

Facility Name: SQUARE CARE MEDICAL & PHARMACY

Facility Address:
8600 E MILL PLAIN BLVD STE A
VANCOUVER, WA
ZIP 98664
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Facility Phone Number: 360 583-4633

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417581943

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	50D2246399
LAB Type	Pharmacy
Facility Name	SQUARE CARE MEDICAL & PHARMACY
Street	8600 E MILL PLAIN BLVD STE A
City	VANCOUVER
State	WA
ZIP	98664
Phone	360 583-4633
CertificateType	4
CertificateEffectiveDate	12/23/2021
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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