20D2199412 CLIA NUMBER - WALGREENS #19253

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Laboratory Demographics

CLIA Number: 20D2199412

Facility Name: WALGREENS #19253

Facility Address:
35 PARK STREET
MILO, ME
ZIP 04463
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Facility Phone Number: 207 943-8570

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053836320

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	20D2199412
LAB Type	Pharmacy
Facility Name	WALGREENS #19253
Street	35 PARK STREET
City	MILO
State	ME
ZIP	04463
Phone	207 943-8570
CertificateType	4
CertificateEffectiveDate	11/9/2022
CertificateExpirationDate	11/8/2024
FacilityType	Waiver

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