47D2026788 CLIA NUMBER - WALGREENS #11526

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Laboratory Demographics

CLIA Number: 47D2026788

Facility Name: WALGREENS #11526

Facility Address:
514 FARRELL ST
BURLINGTON, VT
ZIP 05401
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Facility Phone Number: 802 651-0597

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1538463732

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	47D2026788
LAB Type	Pharmacy
Facility Name	WALGREENS #11526
Street	514 FARRELL ST
City	BURLINGTON
State	VT
ZIP	05401
Phone	802 651-0597
CertificateType	4
CertificateEffectiveDate	4/8/2023
CertificateExpirationDate	4/7/2025
FacilityType	Waiver

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