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14D2044663 CLIA NUMBER - WALGREENS #12303

Laboratory Demographics

CLIA Number: 14D2044663

Facility Name: WALGREENS #12303

Facility Address:
5939 BELLEVILLE CROSSING ST
BELLEVILLE, IL
ZIP 62226
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Facility Phone Number: 618 355-7913

Facility Type: Other - COVID 19 TEST SITE

Certificate Type: Waiver
NPI Number: 1407091523

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 14D2044663
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS #12303
Street 5939 BELLEVILLE CROSSING ST
City BELLEVILLE
State IL
ZIP 62226
Phone 618 355-7913
CertificateType 4
CertificateEffectiveDate 12/23/2022
CertificateExpirationDate 12/22/2024
FacilityType Waiver

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