44D2032268 CLIA NUMBER - WALGREENS #11464

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Laboratory Demographics

CLIA Number: 44D2032268

Facility Name: WALGREENS #11464

Facility Address:
1114 E MAIN ST
BROWNSVILLE, TN
ZIP 38012
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Facility Phone Number: 731 772-1170

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1770772014

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	44D2032268
LAB Type	Pharmacy
Facility Name	WALGREENS #11464
Street	1114 E MAIN ST
City	BROWNSVILLE
State	TN
ZIP	38012
Phone	731 772-1170
CertificateType	4
CertificateEffectiveDate	4/3/2023
CertificateExpirationDate	4/2/2025
FacilityType	Waiver

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