LACKEY CLINIC
NPI 1427582352
Pharmacy - Clinic Pharmacy in Yorktown, VA
NPI Status: Active since April 18, 2017
Contact Information
1620 OLD WILLIAMSBURG RD
YORKTOWN, VA
ZIP 23690
Phone: (757) 886-0608
Fax: (757) 968-5022
- Organization
- Pharmacy
- Clinic Pharmacy
- CLIA Number: 49D0978155
- CLIA Cert. Type: Community Clinic
- CLIA Exp. Date: 11-08-2025
About LACKEY CLINIC
This page provides the complete NPI Profile along with additional information for Lackey Clinic, a provider established in Yorktown, Virginia operating as a Pharmacy, focusing in clinic pharmacy . The healthcare provider is registered in the NPI registry with number 1427582352 assigned on April 2017. The practitioner's primary taxonomy code is 3336C0002X with license number 0201003931 (VA). The provider is registered as an organization and their NPI record was last updated 8 years ago. The provider's is doing business as Lackey Clinic. The authorized official of this NPI record is Carol Sale Rn, Msn (Executive Director)
- NPI
- 1427582352
- Provider Legal Name
- OLIVET MEDICAL MINISTRY, INC
- Other Organization Name
- LACKEY CLINIC
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690
- Location Phone
- (757) 886-0608
- Location Fax
- (757) 968-5022
- Mailing Address
- 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690
- Mailing Phone
- (757) 886-0608
- Mailing Fax
- (757) 968-5022
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-18-2017
- Last Update Date
- 04-18-2017
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Pharmacy Clinic Pharmacy
- Taxonomy Code
- 3336C0002X
- Type
- Suppliers
- License No.
- 0201003931
- License State
- VA
- Taxonomy Description
- A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 49D0978155
- Facility Type
- Community Clinic
- Certificate Effective Date
- November 09, 2023
- Certificate Expiration Date
- November 08, 2025
- Laboratory Director
- RALPH H. ROBERTSON
- Certificate Type
- Certificate for Provider-Performed Microscopy Procedures (PPMP)
- Certificate Type Description
- This CLIA certificate is issued to Lackey Clinic in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 4 | 2 | 7 | 5 | 8 | 2 | 3 | 5 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 4 | 4 | 7 | 10 | 8 | 4 | 3 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 4 + 4 + 7 + 1 + 0 + 8 + 4 + 3 + 1 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1427582352 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 6 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1669602314 | MARGARET H JOHNSON FNP Individual | Nurse Practitioner (Family) | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
| 1699082446 | OLIVET MEDICAL MINISTRY Organization | Clinic/Center (Primary Care) | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
| 1720376676 | MRS. JEAN NMN KEATING ANP Individual | Clinical Nurse Specialist (Adult Health) | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
| 1437447315 | MRS. YOLANDA ANGUS FNP Individual | Nurse Practitioner (Family) | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
| 1083682272 | DR. JILL S COTTEL MD Individual | Internal Medicine | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
| 1205564309 | RACHEL MURRAY MCCLURE Individual | Nurse Practitioner (Family) | 1620 OLD WILLIAMSBURG RD YORKTOWN, VA 23690 (757) 886-0608 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1427582352, enumerated in the NPI registry as an "organization" on April 18, 2017
The provider is located at 1620 Old Williamsburg Rd Yorktown, Va 23690 and the phone number is (757) 886-0608
This medical organization specializes in Pharmacy with taxonomy code 3336C0002X with a focus in Clinic Pharmacy
The provider's CLIA number is 49D0978155 for a "community clinic" facility with a CLIA Certificate for Provider-Performed Microscopy Procedures (PPMP). This CLIA certificate is issued in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing..
This NPI record was last updated on April 18, 2017. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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