27D2011350 CLIA NUMBER - WALGREENS # 09242

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Laboratory Demographics

CLIA Number: 27D2011350

Facility Name: WALGREENS # 09242

Facility Address:
40 W IDAHO ST
KALISPELL, MT
ZIP 59901
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Facility Phone Number: 406 257-0714

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1710992755

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	27D2011350
LAB Type	Pharmacy
Facility Name	WALGREENS # 09242
Street	40 W IDAHO ST
City	KALISPELL
State	MT
ZIP	59901
Phone	406 257-0714
CertificateType	4
CertificateEffectiveDate	4/27/2023
CertificateExpirationDate	4/26/2025
FacilityType	Waiver

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