08D2039869 CLIA NUMBER - WALGREENS # 11073

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Laboratory Demographics

CLIA Number: 08D2039869

Facility Name: WALGREENS # 11073

Facility Address:
120 BROADKILL ROAD
MILTON, DE
ZIP 19968
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Facility Phone Number: 302 684-3184

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720009053

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	08D2039869
LAB Type	Pharmacy
Facility Name	WALGREENS # 11073
Street	120 BROADKILL ROAD
City	MILTON
State	DE
ZIP	19968
Phone	302 684-3184
CertificateType	4
CertificateEffectiveDate	11/4/2023
CertificateExpirationDate	11/3/2025
FacilityType	Waiver

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