13D2034364 CLIA NUMBER - WALGREEN'S #2679

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Laboratory Demographics

CLIA Number: 13D2034364

Facility Name: WALGREEN'S #2679

Facility Address:
2102 NEZ PERCE DRIVE
LEWISTON, ID
ZIP 83501
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Facility Phone Number: (208) 743-4434

Facility Type: PHARMACY

Certificate Type: Waiver

NPI Number: 1225043342

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	13D2034364
LAB Type	PHARMACY
Facility Name	WALGREEN'S #2679
Street	2102 NEZ PERCE DRIVE
City	LEWISTON
State	ID
ZIP	83501
Phone	(208) 743-4434

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