47D2230760 CLIA NUMBER - WALGREENS #17471

Laboratory Demographics

CLIA Number: 47D2230760

Facility Name: WALGREENS #17471

Facility Address:
9 SUSIE WILSON RD
ESSEX JUNCTION, VT
ZIP 05452
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Facility Phone Number: 802 872-1800

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1518480169

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	47D2230760
LAB Type	Pharmacy
Facility Name	WALGREENS #17471
Street	9 SUSIE WILSON RD
City	ESSEX JUNCTION
State	VT
ZIP	05452
Phone	802 872-1800
CertificateType	4
CertificateEffectiveDate	7/28/2023
CertificateExpirationDate	7/27/2025
FacilityType	Waiver

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