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44D2287623 CLIA NUMBER - WALGREENS #17551

Laboratory Demographics

CLIA Number: 44D2287623

Facility Name: WALGREENS #17551

Facility Address:
409 MULBERRY
SELMER, TN
ZIP 38375
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Facility Phone Number: 731 645-4423

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1194240473

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 44D2287623
LAB Type Pharmacy
Facility Name WALGREENS #17551
Street 409 MULBERRY
City SELMER
State TN
ZIP 38375
Phone 731 645-4423
CertificateType 4
CertificateEffectiveDate 8/16/2023
CertificateExpirationDate 8/15/2025
FacilityType Waiver

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