36D2011445 CLIA NUMBER - WALGREENS #02136

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Laboratory Demographics

CLIA Number: 36D2011445

Facility Name: WALGREENS #02136

Facility Address:
4090 EAST GALBRAITH ROAD
DEER PARK, OH
ZIP 45236
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Facility Phone Number: 513 891-2808

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235144239

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	36D2011445
LAB Type	Pharmacy
Facility Name	WALGREENS #02136
Street	4090 EAST GALBRAITH ROAD
City	DEER PARK
State	OH
ZIP	45236
Phone	513 891-2808
CertificateType	4
CertificateEffectiveDate	8/10/2023
CertificateExpirationDate	8/9/2025
FacilityType	Waiver

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