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33D2293887 CLIA NUMBER - WALGREENS NO 19035

Laboratory Demographics

CLIA Number: 33D2293887

Facility Name: WALGREENS NO 19035

Facility Address:
162-19 HILLSIDE AVENUE
JAMAICA, NY
ZIP 11432
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Facility Phone Number: 718 739-3451

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1306360102

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 33D2293887
LAB Type Pharmacy
Facility Name WALGREENS NO 19035
Street 162-19 HILLSIDE AVENUE
City JAMAICA
State NY
ZIP 11432
Phone 718 739-3451
CertificateType 4
CertificateEffectiveDate 11/16/2023
CertificateExpirationDate 3/26/2027
FacilityType Waiver

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