50D2253063 CLIA NUMBER - PURDY COSTLESS PHARMACY

Laboratory Demographics

CLIA Number: 50D2253063

Facility Name: PURDY COSTLESS PHARMACY

Facility Address:
14218 92ND AVE NW
GIG HARBOR, WA
ZIP 98329
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Facility Phone Number: 253 857-7797

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1205580933

Taxonomy: 3336L0003X - Pharmacy
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

CLIA Record

Field Name	Field Value
CLIA Number	50D2253063
LAB Type	Pharmacy
Facility Name	PURDY COSTLESS PHARMACY
Street	14218 92ND AVE NW
City	GIG HARBOR
State	WA
ZIP	98329
Phone	253 857-7797
CertificateType	4
CertificateEffectiveDate	2/16/2022
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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