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33D2243372 CLIA NUMBER - WALGREENS NO 05956

Laboratory Demographics

CLIA Number: 33D2243372

Facility Name: WALGREENS NO 05956

Facility Address:
275 BROADWAY
AMITYVILLE, NY
ZIP 11701
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Facility Phone Number: 631 841-1630

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1609881770

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 33D2243372
LAB Type Pharmacy
Facility Name WALGREENS NO 05956
Street 275 BROADWAY
City AMITYVILLE
State NY
ZIP 11701
Phone 631 841-1630
CertificateType 4
CertificateEffectiveDate 11/18/2021
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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