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41D2230774 CLIA NUMBER - WALGREENS #19761

Laboratory Demographics

CLIA Number: 41D2230774

Facility Name: WALGREENS #19761

Facility Address:
1510 SMITH ST
NORTH PROVIDENCE, RI
ZIP 02911
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Facility Phone Number: 401 353-3500

Facility Type: Physician Office

Certificate Type: Waiver
NPI Number: 1669995502

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 41D2230774
LAB Type Physician Office
Facility Name WALGREENS #19761
Street 1510 SMITH ST
City NORTH PROVIDENCE
State RI
ZIP 02911
Phone 401 353-3500
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