26D2056439 CLIA NUMBER - WALGREENS #02901

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Laboratory Demographics

CLIA Number: 26D2056439

Facility Name: WALGREENS #02901

Facility Address:
1705 SHACKELFORD RD
FLORISSANT, MO
ZIP 63031
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Facility Phone Number: 314 831-5559

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1891701363

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	26D2056439
LAB Type	Pharmacy
Facility Name	WALGREENS #02901
Street	1705 SHACKELFORD RD
City	FLORISSANT
State	MO
ZIP	63031
Phone	314 831-5559
CertificateType	4
CertificateEffectiveDate	6/4/2023
CertificateExpirationDate	6/3/2025
FacilityType	Waiver

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