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20D2291351 CLIA NUMBER - WALGREENS 19606

Laboratory Demographics

CLIA Number: 20D2291351

Facility Name: WALGREENS 19606

Facility Address:
464 MAIN ST
SPRINGVALE, ME
ZIP 04083
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Facility Phone Number: 207 324-1222

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1891219960

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 20D2291351
LAB Type Pharmacy
Facility Name WALGREENS 19606
Street 464 MAIN ST
City SPRINGVALE
State ME
ZIP 04083
Phone 207 324-1222
CertificateType 4
CertificateEffectiveDate 10/10/2023
CertificateExpirationDate 10/9/2025
FacilityType Waiver

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