44D2032543 CLIA NUMBER - WALGREENS #10495

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Laboratory Demographics

CLIA Number: 44D2032543

Facility Name: WALGREENS #10495

Facility Address:
121 HARRISON LN
SODDY DAISY, TN
ZIP 37379
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Facility Phone Number: 423 332-5124

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1235237314

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	44D2032543
LAB Type	Pharmacy
Facility Name	WALGREENS #10495
Street	121 HARRISON LN
City	SODDY DAISY
State	TN
ZIP	37379
Phone	423 332-5124
CertificateType	4
CertificateEffectiveDate	3/20/2023
CertificateExpirationDate	3/19/2025
FacilityType	Waiver

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