25D2037849 CLIA NUMBER - WALGREENS #04172

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Laboratory Demographics

CLIA Number: 25D2037849

Facility Name: WALGREENS #04172

Facility Address:
2405 PASS ROAD
BILOXI, MS
ZIP 39531
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Facility Phone Number: 228 388-3458

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1669487823

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	25D2037849
LAB Type	Pharmacy
Facility Name	WALGREENS #04172
Street	2405 PASS ROAD
City	BILOXI
State	MS
ZIP	39531
Phone	228 388-3458
CertificateType	4
CertificateEffectiveDate	4/13/2023
CertificateExpirationDate	4/12/2025
FacilityType	Waiver

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