44D2032288 CLIA NUMBER - WALGREENS #11852

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Laboratory Demographics

CLIA Number: 44D2032288

Facility Name: WALGREENS #11852

Facility Address:
1751 TINY TOWN RD
CLARKSVILLE, TN
ZIP 37042
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Facility Phone Number: 931 552-7464

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1376701789

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	44D2032288
LAB Type	Pharmacy
Facility Name	WALGREENS #11852
Street	1751 TINY TOWN RD
City	CLARKSVILLE
State	TN
ZIP	37042
Phone	931 552-7464
CertificateType	4
CertificateEffectiveDate	5/24/2023
CertificateExpirationDate	5/23/2025
FacilityType	Waiver

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