44D2032485 CLIA NUMBER - WALGREENS #12513

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Laboratory Demographics

CLIA Number: 44D2032485

Facility Name: WALGREENS #12513

Facility Address:
606 S CUMBERLAND ST
LEBANON, TN
ZIP 37087
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Facility Phone Number: 615 449-7770

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1124544473

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	44D2032485
LAB Type	Pharmacy
Facility Name	WALGREENS #12513
Street	606 S CUMBERLAND ST
City	LEBANON
State	TN
ZIP	37087
Phone	615 449-7770
CertificateType	4
CertificateEffectiveDate	3/9/2023
CertificateExpirationDate	3/8/2025
FacilityType	Waiver

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