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07D2225143 CLIA NUMBER - WALGREENS #03579

Laboratory Demographics

CLIA Number: 07D2225143

Facility Name: WALGREENS #03579

Facility Address:
1471 WHALLEY AVE
NEW HAVEN, CT
ZIP 06515
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Facility Phone Number: 203 389-2143

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1740295096

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 07D2225143
LAB Type Pharmacy
Facility Name WALGREENS #03579
Street 1471 WHALLEY AVE
City NEW HAVEN
State CT
ZIP 06515
Phone 203 389-2143
CertificateType 4
CertificateEffectiveDate 5/19/2023
CertificateExpirationDate 5/18/2025
FacilityType Waiver

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