26D2012176 CLIA NUMBER - WALGREENS #03690

Laboratory Demographics

CLIA Number: 26D2012176

Facility Name: WALGREENS #03690

Facility Address:
2640 E SUNSHINE ST
SPRINGFIELD, MO
ZIP 65804
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Facility Phone Number: 417 885-1274

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1821003070

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 26D2012176
LAB Type Pharmacy
Facility Name WALGREENS #03690
Street 2640 E SUNSHINE ST
City SPRINGFIELD
State MO
ZIP 65804
Phone 417 885-1274
CertificateType 4
CertificateEffectiveDate 5/26/2023
CertificateExpirationDate 5/25/2025
FacilityType Waiver

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