38D2288212 CLIA NUMBER - WALGREENS # 07120

Laboratory Demographics

CLIA Number: 38D2288212

Facility Name: WALGREENS # 07120

Facility Address:
603 SE BAKER ST
MCMINNVILLE, OR
ZIP 97128
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Facility Phone Number: 503 474-3795

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1053326041

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	38D2288212
LAB Type	Pharmacy
Facility Name	WALGREENS # 07120
Street	603 SE BAKER ST
City	MCMINNVILLE
State	OR
ZIP	97128
Phone	503 474-3795
CertificateType	4
CertificateEffectiveDate	8/23/2023
CertificateExpirationDate	8/22/2025
FacilityType	Waiver

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