13D2033704 CLIA NUMBER - WALGREEN'S #11541

Laboratory Demographics

CLIA Number: 13D2033704

Facility Name: WALGREEN'S #11541

Facility Address:
4110 S 10TH AVE
CALDWELL, ID
ZIP 83605
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Facility Phone Number: (208) 402-0154

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1902087794

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 13D2033704
LAB Type PHARMACY
Facility Name WALGREEN'S #11541
Street 4110 S 10TH AVE
City CALDWELL
State ID
ZIP 83605
Phone (208) 402-0154

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This page was last updated on: 5/11/2023