20D2200374 CLIA NUMBER - WALGREENS #18119

Home > CLIA Lookup > 20D2200374

Laboratory Demographics

CLIA Number: 20D2200374

Facility Name: WALGREENS #18119

Facility Address:
15 SACO AVE
OLD ORCHARD BEACH, ME
ZIP 04064
Get Directions

Facility Phone Number: 207 934-1000

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1417472853

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	20D2200374
LAB Type	Pharmacy
Facility Name	WALGREENS #18119
Street	15 SACO AVE
City	OLD ORCHARD BEACH
State	ME
ZIP	04064
Phone	207 934-1000
CertificateType	4
CertificateEffectiveDate	11/16/2022
CertificateExpirationDate	11/15/2024
FacilityType	Waiver

Download Record

Export to text format icon Download this CLIA NUMBER record in Text format: Export

Export to text format icon Download this CLIA NUMBER record in Excel (CSV) format: Export

Export to text format icon Download this CLIA NUMBER record in XML format: Export

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