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41D2291030 CLIA NUMBER - WALGREENS 19849

Laboratory Demographics

CLIA Number: 41D2291030

Facility Name: WALGREENS 19849

Facility Address:
655 WARREN AVE
EAST PROVIDENCE, RI
ZIP 02914
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Facility Phone Number: 401 434-5700

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1396269882

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 41D2291030
LAB Type Pharmacy
Facility Name WALGREENS 19849
Street 655 WARREN AVE
City EAST PROVIDENCE
State RI
ZIP 02914
Phone 401 434-5700
CertificateType 4
CertificateEffectiveDate 10/4/2023
CertificateExpirationDate 10/3/2025
FacilityType Waiver

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