33D2240539 CLIA NUMBER - WALGREENS NO 18074

Laboratory Demographics

CLIA Number: 33D2240539

Facility Name: WALGREENS NO 18074

Facility Address:
73 N MAIN ST
BROCKPORT, NY
ZIP 14420
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Facility Phone Number: 585 637-1151

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053835629

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	33D2240539
LAB Type	Pharmacy
Facility Name	WALGREENS NO 18074
Street	73 N MAIN ST
City	BROCKPORT
State	NY
ZIP	14420
Phone	585 637-1151
CertificateType	4
CertificateEffectiveDate	10/20/2021
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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