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29D2225095 CLIA NUMBER - WALGREENS #04579

Laboratory Demographics

CLIA Number: 29D2225095

Facility Name: WALGREENS #04579

Facility Address:
2400 E TROPICANA AVE
LAS VEGAS, NV
ZIP 89121
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Facility Phone Number: 702 435-6289

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1306853288

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 29D2225095
LAB Type Pharmacy
Facility Name WALGREENS #04579
Street 2400 E TROPICANA AVE
City LAS VEGAS
State NV
ZIP 89121
Phone 702 435-6289
CertificateType 4
CertificateEffectiveDate 5/18/2023
CertificateExpirationDate 5/17/2025
FacilityType Waiver

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