46D2289898 CLIA NUMBER - WALGREENS 19999

Laboratory Demographics

CLIA Number: 46D2289898

Facility Name: WALGREENS 19999

Facility Address:
5540 SOUTH 900 EAST
SALT LAKE CITY, UT
ZIP 84117
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Facility Phone Number: 801 262-2981

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1114440120

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	46D2289898
LAB Type	Pharmacy
Facility Name	WALGREENS 19999
Street	5540 SOUTH 900 EAST
City	SALT LAKE CITY
State	UT
ZIP	84117
Phone	801 262-2981
CertificateType	4
CertificateEffectiveDate	9/18/2023
CertificateExpirationDate	9/17/2025
FacilityType	Waiver

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