26D2039742 CLIA NUMBER - WALGREENS #05287

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Laboratory Demographics

CLIA Number: 26D2039742

Facility Name: WALGREENS #05287

Facility Address:
1155 EAST ST LOUIS STREET
SPRINGFIELD, MO
ZIP 65806
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Facility Phone Number: 417 862-5302

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1245245265

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	26D2039742
LAB Type	Pharmacy
Facility Name	WALGREENS #05287
Street	1155 EAST ST LOUIS STREET
City	SPRINGFIELD
State	MO
ZIP	65806
Phone	417 862-5302
CertificateType	4
CertificateEffectiveDate	4/7/2023
CertificateExpirationDate	4/6/2025
FacilityType	Waiver

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