20D2200369 CLIA NUMBER - WALGREENS #18248

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Laboratory Demographics

CLIA Number: 20D2200369

Facility Name: WALGREENS #18248

Facility Address:
112 BENNETT DR
CARIBOU, ME
ZIP 04736
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Facility Phone Number: 207 498-8735

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1609390681

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	20D2200369
LAB Type	Pharmacy
Facility Name	WALGREENS #18248
Street	112 BENNETT DR
City	CARIBOU
State	ME
ZIP	04736
Phone	207 498-8735
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