32D2011738 CLIA NUMBER - WALGREENS #04421

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Laboratory Demographics

CLIA Number: 32D2011738

Facility Name: WALGREENS #04421

Facility Address:
3100 N MAIN STREET
LAS CRUCES, NM
ZIP 88001
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Facility Phone Number: 575 525-0298

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1578578621

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	32D2011738
LAB Type	Pharmacy
Facility Name	WALGREENS #04421
Street	3100 N MAIN STREET
City	LAS CRUCES
State	NM
ZIP	88001
Phone	575 525-0298
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