28D2013581 CLIA NUMBER - WALGREENS #12115

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Laboratory Demographics

CLIA Number: 28D2013581

Facility Name: WALGREENS #12115

Facility Address:
2320 23RD STREET
COLUMBUS, NE
ZIP 68601
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Facility Phone Number: 402 563-3588

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1700891751

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	28D2013581
LAB Type	Pharmacy
Facility Name	WALGREENS #12115
Street	2320 23RD STREET
City	COLUMBUS
State	NE
ZIP	68601
Phone	402 563-3588
CertificateType	4
CertificateEffectiveDate	5/4/2023
CertificateExpirationDate	5/3/2025
FacilityType	Waiver

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