33D2295843 CLIA NUMBER - WALGREENS NO 04445

Laboratory Demographics

CLIA Number: 33D2295843

Facility Name: WALGREENS NO 04445

Facility Address:
11902 ROCKAWAY BLVD
SOUTH OZONE PARK, NY
ZIP 11420
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Facility Phone Number: 718 529-9503

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1639184781

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	33D2295843
LAB Type	Pharmacy
Facility Name	WALGREENS NO 04445
Street	11902 ROCKAWAY BLVD
City	SOUTH OZONE PARK
State	NY
ZIP	11420
Phone	718 529-9503
CertificateType	4
CertificateEffectiveDate	12/18/2023
CertificateExpirationDate	3/26/2027
FacilityType	Waiver

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