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40D2255612 CLIA NUMBER - WALGREENS # 00121

Laboratory Demographics

CLIA Number: 40D2255612

Facility Name: WALGREENS # 00121

Facility Address:
106 CALLE PIEL CANELA
COAMO, PR
ZIP 00769
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Facility Phone Number: 787 803-6802

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1962417022

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 40D2255612
LAB Type Pharmacy
Facility Name WALGREENS # 00121
Street 106 CALLE PIEL CANELA
City COAMO
State PR
ZIP 00769
Phone 787 803-6802
CertificateType 4
CertificateEffectiveDate 3/16/2024
CertificateExpirationDate 3/15/2026
FacilityType Waiver

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