41D2230784 CLIA NUMBER - WALGREENS #03491

Laboratory Demographics

CLIA Number: 41D2230784

Facility Name: WALGREENS #03491

Facility Address:
1763 BROAD ST
CRANSTON, RI
ZIP 02905
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Facility Phone Number: 401 461-6770

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1558794685

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	41D2230784
LAB Type	Pharmacy
Facility Name	WALGREENS #03491
Street	1763 BROAD ST
City	CRANSTON
State	RI
ZIP	02905
Phone	401 461-6770
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