32D1093558 CLIA NUMBER - WALGREENS #05350

Laboratory Demographics

CLIA Number: 32D1093558

Facility Name: WALGREENS #05350

Facility Address:
1835 N MAIN STREET
ROSWELL, NM
ZIP 88201
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Facility Phone Number: 575 624-0423

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1801801709

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	32D1093558
LAB Type	Pharmacy
Facility Name	WALGREENS #05350
Street	1835 N MAIN STREET
City	ROSWELL
State	NM
ZIP	88201
Phone	575 624-0423
CertificateType	4
CertificateEffectiveDate	5/6/2023
CertificateExpirationDate	5/5/2025
FacilityType	Waiver

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