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07D2288461 CLIA NUMBER - WALGREENS # 17216

Laboratory Demographics

CLIA Number: 07D2288461

Facility Name: WALGREENS # 17216

Facility Address:
27 BROADWAY
COLCHESTER, CT
ZIP 06415
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Facility Phone Number: 860 537-9034

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1851814867

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 07D2288461
LAB Type Pharmacy
Facility Name WALGREENS # 17216
Street 27 BROADWAY
City COLCHESTER
State CT
ZIP 06415
Phone 860 537-9034
CertificateType 4
CertificateEffectiveDate 8/25/2023
CertificateExpirationDate 8/24/2025
FacilityType Waiver

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