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14D2015082 CLIA NUMBER - WALGREENS # 03633

Laboratory Demographics

CLIA Number: 14D2015082

Facility Name: WALGREENS # 03633

Facility Address:
4000 AVENUE OF THE CITIES
MOLINE, IL
ZIP 61265
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Facility Phone Number: 309 797-2588

Facility Type: Other - COVID TESTING

Certificate Type: Waiver
NPI Number: 1407863400

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 14D2015082
LAB Type Other - COVID TESTING
Facility Name WALGREENS # 03633
Street 4000 AVENUE OF THE CITIES
City MOLINE
State IL
ZIP 61265
Phone 309 797-2588
CertificateType 4
CertificateEffectiveDate 1/27/2023
CertificateExpirationDate 1/26/2025
FacilityType Waiver

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