20D2199614 CLIA NUMBER - WALGREENS #19423

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Laboratory Demographics

CLIA Number: 20D2199614

Facility Name: WALGREENS #19423

Facility Address:
478 ROUTE 1
YARMOUTH, ME
ZIP 04096
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Facility Phone Number: 207 846-1222

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1720503782

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	20D2199614
LAB Type	Pharmacy
Facility Name	WALGREENS #19423
Street	478 ROUTE 1
City	YARMOUTH
State	ME
ZIP	04096
Phone	207 846-1222
CertificateType	4
CertificateEffectiveDate	11/10/2022
CertificateExpirationDate	11/9/2024
FacilityType	Waiver

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