28D2221853 CLIA NUMBER - WALGREENS #11089

Laboratory Demographics

CLIA Number: 28D2221853

Facility Name: WALGREENS #11089

Facility Address:
5500 RED ROCK LN
LINCOLN, NE
ZIP 68516
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Facility Phone Number: 402 421-2122

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790994879

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	28D2221853
LAB Type	Pharmacy
Facility Name	WALGREENS #11089
Street	5500 RED ROCK LN
City	LINCOLN
State	NE
ZIP	68516
Phone	402 421-2122
CertificateType	4
CertificateEffectiveDate	4/26/2023
CertificateExpirationDate	4/25/2025
FacilityType	Waiver

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