20D2200355 CLIA NUMBER - WALGREENS #17473

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Laboratory Demographics

CLIA Number: 20D2200355

Facility Name: WALGREENS #17473

Facility Address:
28 PARK ST
ROCKLAND, ME
ZIP 04841
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Facility Phone Number: 207 596-0036

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1265957062

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	20D2200355
LAB Type	Pharmacy
Facility Name	WALGREENS #17473
Street	28 PARK ST
City	ROCKLAND
State	ME
ZIP	04841
Phone	207 596-0036
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

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