36D2007757 CLIA NUMBER - WALGREENS #11511

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Laboratory Demographics

CLIA Number: 36D2007757

Facility Name: WALGREENS #11511

Facility Address:
1001 WEST STATE STREET
TRENTON, OH
ZIP 45067
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Facility Phone Number: 513 737-3504

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1215143052

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	36D2007757
LAB Type	Pharmacy
Facility Name	WALGREENS #11511
Street	1001 WEST STATE STREET
City	TRENTON
State	OH
ZIP	45067
Phone	513 737-3504
CertificateType	4
CertificateEffectiveDate	3/2/2023
CertificateExpirationDate	3/1/2025
FacilityType	Waiver

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