13D2034633 CLIA NUMBER - WALGREENS #06971

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Laboratory Demographics

CLIA Number: 13D2034633

Facility Name: WALGREENS #06971

Facility Address:
2285 S APPLE STREET
BOISE, ID
ZIP 83706
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Facility Phone Number: 208 336-3956

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053326173

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	13D2034633
LAB Type	Pharmacy
Facility Name	WALGREENS #06971
Street	2285 S APPLE STREET
City	BOISE
State	ID
ZIP	83706
Phone	208 336-3956
CertificateType	4
CertificateEffectiveDate	5/18/2023
CertificateExpirationDate	5/17/2025
FacilityType	Waiver

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