13D2034134 CLIA NUMBER - WALGREEN'S #06380

Home > CLIA Lookup > 13D2034134

Laboratory Demographics

CLIA Number: 13D2034134

Facility Name: WALGREEN'S #06380

Facility Address:
905 YELLOWSTONE AVE
POCATELLO, ID
ZIP 83201
Get Directions

Facility Phone Number: 208 233-2382

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1144235268

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	13D2034134
LAB Type	Pharmacy
Facility Name	WALGREEN'S #06380
Street	905 YELLOWSTONE AVE
City	POCATELLO
State	ID
ZIP	83201
Phone	208 233-2382
CertificateType	4
CertificateEffectiveDate	2/5/2023
CertificateExpirationDate	2/4/2025
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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