28D2062852 CLIA NUMBER - WALGREENS #11957

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Laboratory Demographics

CLIA Number: 28D2062852

Facility Name: WALGREENS #11957

Facility Address:
1260 WASHINGTON STREET
BLAIR, NE
ZIP 68008
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Facility Phone Number: 402 533-8444

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1275796807

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	28D2062852
LAB Type	Pharmacy
Facility Name	WALGREENS #11957
Street	1260 WASHINGTON STREET
City	BLAIR
State	NE
ZIP	68008
Phone	402 533-8444
CertificateType	4
CertificateEffectiveDate	5/10/2023
CertificateExpirationDate	5/9/2025
FacilityType	Waiver

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