26D2013050 CLIA NUMBER - WALGREENS #05717

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Laboratory Demographics

CLIA Number: 26D2013050

Facility Name: WALGREENS #05717

Facility Address:
890 WASHINGTON CORS
WASHINGTON, MO
ZIP 63090
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Facility Phone Number: 636 239-7483

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710992748

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	26D2013050
LAB Type	Pharmacy
Facility Name	WALGREENS #05717
Street	890 WASHINGTON CORS
City	WASHINGTON
State	MO
ZIP	63090
Phone	636 239-7483
CertificateType	4
CertificateEffectiveDate	3/25/2023
CertificateExpirationDate	3/24/2025
FacilityType	Waiver

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