17D2011254 CLIA NUMBER - WALGREENS #03055

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Laboratory Demographics

CLIA Number: 17D2011254

Facility Name: WALGREENS #03055

Facility Address:
3421 W 6TH STREET
LAWRENCE, KS
ZIP 66049
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Facility Phone Number: 785 841-9000

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1225043540

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	17D2011254
LAB Type	Pharmacy
Facility Name	WALGREENS #03055
Street	3421 W 6TH STREET
City	LAWRENCE
State	KS
ZIP	66049
Phone	785 841-9000
CertificateType	4
CertificateEffectiveDate	3/22/2023
CertificateExpirationDate	3/21/2025
FacilityType	Waiver

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