01D2229730 CLIA NUMBER - WALGREENS #09976

Laboratory Demographics

CLIA Number: 01D2229730

Facility Name: WALGREENS #09976

Facility Address:
1127 6TH AVE SE
DECATUR, AL
ZIP 35601
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Facility Phone Number: 256 355-4495

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1629142419

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 01D2229730
LAB Type Pharmacy
Facility Name WALGREENS #09976
Street 1127 6TH AVE SE
City DECATUR
State AL
ZIP 35601
Phone 256 355-4495
CertificateType 4
CertificateEffectiveDate 7/15/2023
CertificateExpirationDate 7/14/2025
FacilityType Waiver

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