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33D2226513 CLIA NUMBER - WALGREENS #15160

Laboratory Demographics

CLIA Number: 33D2226513

Facility Name: WALGREENS #15160

Facility Address:
655 ROSSVILLE AVE
STATEN ISLAND, NY
ZIP 10309
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Facility Phone Number: 718 967-2955

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1386990323

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 33D2226513
LAB Type Pharmacy
Facility Name WALGREENS #15160
Street 655 ROSSVILLE AVE
City STATEN ISLAND
State NY
ZIP 10309
Phone 718 967-2955
CertificateType 4
CertificateEffectiveDate 6/1/2021
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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