05D2222014 CLIA NUMBER - WALGREENS #11612

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Laboratory Demographics

CLIA Number: 05D2222014

Facility Name: WALGREENS #11612

Facility Address:
12 W HANFORD ARMONA RD
LEMOORE, CA
ZIP 93245
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Facility Phone Number: 559 925-6510

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1134384290

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	05D2222014
LAB Type	Pharmacy
Facility Name	WALGREENS #11612
Street	12 W HANFORD ARMONA RD
City	LEMOORE
State	CA
ZIP	93245
Phone	559 925-6510
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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