LACKEY CLINIC
NPI 1427582352
Pharmacy - Clinic Pharmacy in Yorktown, VA

Q: What is Olivet Medical Ministry, Inc's NPI number?

The NPI number for Olivet Medical Ministry, Inc is 1427582352. It was assigned to this organization in the NPPES registry on April 18, 2017. The provider is doing business as Lackey Clinic.

Q: What is Olivet Medical Ministry, Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Clinic Pharmacy, with taxonomy code 3336C0002X.

Active since April 18, 2017CLIA 49D0978155 · Microscopy

1620 OLD WILLIAMSBURG RD, YORKTOWN, VA 23690(757) 886-0608(757) 968-5022 Get Directions Write a Review

NPPES record last updated: April 18, 2017. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Lackey Clinic NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LACKEY CLINIC (NPI 1427582352) is a healthcare organization registered as a clinic pharmacy in Yorktown, Virginia and active in the NPI registry since April 2017. The organization holds a CLIA Microscopy certificate valid through November 8, 2027 and lists Carol Sale, Executive Director, as its authorized official.

NPPES Registry Identity

NPI1427582352

Entity TypeOrganization

Primary Taxonomy3336C0002X

Legal Business NameOLIVET MEDICAL MINISTRY, INC

Location Address1620 OLD WILLIAMSBURG RDYorktown, VA 23690-3910

Mailing Address1620 Old Williamsburg RdYorktown, VA 23690-3910 · (757) 886-0608 · Fax (757) 968-5022

Phone(757) 886-0608

Fax(757) 968-5022

Organization SubpartNo

Authorized OfficialCarol SaleExecutive Director · (757) 886-0608

Enumeration DateApril 18, 2017

✔ NPI 1427582352 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Clinic PharmacySuppliers

Taxonomy Code3336C0002X

License✔ Licensed in VA · 0201003931

Definition

A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.

1620 OLD WILLIAMSBURG RD, Yorktown, VA 23690

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Other Names 1

Doing Business AsLackey Clinic

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 49D0978155

Olivet Medical Ministry T/A Lackey Free Family Medicial Clinic · Yorktown, VA

Active · expires Nov 8, 2027

CLIA Number49D0978155

Laboratory TypeCommunity Clinic

Certificate Effective DateNovember 9, 2025

Certificate Expiration DateNovember 8, 2027

Laboratory DirectorRalph H. Robertson

Laboratory Phone(757) 886-0608

Laboratory LocationOlivet Medical Ministry T/A Lackey Free Family Medicial Clinic1620 Old Williamsburg Road Attn Terri Barras, Yorktown, VA 23690

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DIANNE MARIE GUSE RPH

Pharmacist