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13D2034072 CLIA NUMBER - WALGREEN'S #07277

Laboratory Demographics

CLIA Number: 13D2034072

Facility Name: WALGREEN'S #07277

Facility Address:
306 BLUE LAKES BLVD N
TWIN FALLS, ID
ZIP 83301
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Facility Phone Number: 208 734-4053

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1780699801

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 13D2034072
LAB Type Pharmacy
Facility Name WALGREEN'S #07277
Street 306 BLUE LAKES BLVD N
City TWIN FALLS
State ID
ZIP 83301
Phone 208 734-4053
CertificateType 4
CertificateEffectiveDate 4/14/2023
CertificateExpirationDate 4/13/2025
FacilityType Waiver

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