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12D2217608 CLIA NUMBER - WALGREENS #12786

Laboratory Demographics

CLIA Number: 12D2217608

Facility Name: WALGREENS #12786

Facility Address:
10 E KAMEHAMEHA AVE
KAHULUI, HI
ZIP 96732
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Facility Phone Number: 808 872-3301

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043541774

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 12D2217608
LAB Type Pharmacy
Facility Name WALGREENS #12786
Street 10 E KAMEHAMEHA AVE
City KAHULUI
State HI
ZIP 96732
Phone 808 872-3301
CertificateType 4
CertificateEffectiveDate 3/22/2023
CertificateExpirationDate 3/21/2025
FacilityType Waiver

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