32D2011514 CLIA NUMBER - WALGREENS #09067

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Laboratory Demographics

CLIA Number: 32D2011514

Facility Name: WALGREENS #09067

Facility Address:
701 E 20TH ST
FARMINGTON, NM
ZIP 87401
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Facility Phone Number: 505 326-3342

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1619982519

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	32D2011514
LAB Type	Pharmacy
Facility Name	WALGREENS #09067
Street	701 E 20TH ST
City	FARMINGTON
State	NM
ZIP	87401
Phone	505 326-3342
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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