33D2294290 CLIA NUMBER - WALGREENS NO 13866

Laboratory Demographics

CLIA Number: 33D2294290

Facility Name: WALGREENS NO 13866

Facility Address:
302 ROUTE 25A
MILLER PLACE, NY
ZIP 11764
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Facility Phone Number: 631 331-3162

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1285072108

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	33D2294290
LAB Type	Pharmacy
Facility Name	WALGREENS NO 13866
Street	302 ROUTE 25A
City	MILLER PLACE
State	NY
ZIP	11764
Phone	631 331-3162
CertificateType	4
CertificateEffectiveDate	11/21/2023
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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