08D2038537 CLIA NUMBER - WALGREENS #11055

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Laboratory Demographics

CLIA Number: 08D2038537

Facility Name: WALGREENS #11055

Facility Address:
4465 SUMMIT BRIDGE ROAD
MIDDLETOWN, DE
ZIP 19709
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Facility Phone Number: 302 376-1600

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1366461444

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	08D2038537
LAB Type	Pharmacy
Facility Name	WALGREENS #11055
Street	4465 SUMMIT BRIDGE ROAD
City	MIDDLETOWN
State	DE
ZIP	19709
Phone	302 376-1600
CertificateType	4
CertificateEffectiveDate	9/1/2023
CertificateExpirationDate	8/31/2025
FacilityType	Waiver

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