13D2033651 CLIA NUMBER - WALGREEN'S #07276

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Laboratory Demographics

CLIA Number: 13D2033651

Facility Name: WALGREEN'S #07276

Facility Address:
1012 E CLEVELAND BLVD
CALDWELL, ID
ZIP 83605
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Facility Phone Number: 208 455-1792

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1871508994

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	13D2033651
LAB Type	Pharmacy
Facility Name	WALGREEN'S #07276
Street	1012 E CLEVELAND BLVD
City	CALDWELL
State	ID
ZIP	83605
Phone	208 455-1792
CertificateType	4
CertificateEffectiveDate	2/9/2023
CertificateExpirationDate	2/8/2025
FacilityType	Waiver

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