17D2038582 CLIA NUMBER - WALGREENS #9049

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Laboratory Demographics

CLIA Number: 17D2038582

Facility Name: WALGREENS #9049

Facility Address:
1911 NORTH BROADWAY STREET
PITTSBURG, KS
ZIP 66762
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Facility Phone Number: 620 231-1486

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1588679708

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	17D2038582
LAB Type	Pharmacy
Facility Name	WALGREENS #9049
Street	1911 NORTH BROADWAY STREET
City	PITTSBURG
State	KS
ZIP	66762
Phone	620 231-1486
CertificateType	4
CertificateEffectiveDate	4/14/2023
CertificateExpirationDate	4/13/2025
FacilityType	Waiver

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