26D2052993 CLIA NUMBER - WALGREENS #02616

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Laboratory Demographics

CLIA Number: 26D2052993

Facility Name: WALGREENS #02616

Facility Address:
455 HIGHWAY 61 N
HANNIBAL, MO
ZIP 63401
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Facility Phone Number: 573 221-6557

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1194730341

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	26D2052993
LAB Type	Pharmacy
Facility Name	WALGREENS #02616
Street	455 HIGHWAY 61 N
City	HANNIBAL
State	MO
ZIP	63401
Phone	573 221-6557
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