46D2287382 CLIA NUMBER - WALGREENS 18974

Laboratory Demographics

CLIA Number: 46D2287382

Facility Name: WALGREENS 18974

Facility Address:
2332 EAST 21ST SOUTH
SALT LAKE CITY, UT
ZIP 84109
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Facility Phone Number: 801 466-9949

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1659894707

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	46D2287382
LAB Type	Pharmacy
Facility Name	WALGREENS 18974
Street	2332 EAST 21ST SOUTH
City	SALT LAKE CITY
State	UT
ZIP	84109
Phone	801 466-9949
CertificateType	4
CertificateEffectiveDate	8/14/2023
CertificateExpirationDate	8/13/2025
FacilityType	Waiver

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