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36D2230897 CLIA NUMBER - WALGREENS #04044

Laboratory Demographics

CLIA Number: 36D2230897

Facility Name: WALGREENS #04044

Facility Address:
1223 CLEVELAND AVE NW
CANTON, OH
ZIP 44703
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Facility Phone Number: 330 453-4874

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1043225063

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 36D2230897
LAB Type Pharmacy
Facility Name WALGREENS #04044
Street 1223 CLEVELAND AVE NW
City CANTON
State OH
ZIP 44703
Phone 330 453-4874
CertificateType 4
CertificateEffectiveDate 7/28/2023
CertificateExpirationDate 7/27/2025
FacilityType Waiver

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