34D2039239 CLIA NUMBER - WALGREENS #11893

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Laboratory Demographics

CLIA Number: 34D2039239

Facility Name: WALGREENS #11893

Facility Address:
115 W MAIN ST
BEULAVILLE, NC
ZIP 28518
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Facility Phone Number: 910 298-9172

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1902042708

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	34D2039239
LAB Type	Pharmacy
Facility Name	WALGREENS #11893
Street	115 W MAIN ST
City	BEULAVILLE
State	NC
ZIP	28518
Phone	910 298-9172
CertificateType	4
CertificateEffectiveDate	8/4/2023
CertificateExpirationDate	8/3/2025
FacilityType	Waiver

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