47D2243555 CLIA NUMBER - WALGREENS #19570

Laboratory Demographics

CLIA Number: 47D2243555

Facility Name: WALGREENS #19570

Facility Address:
1024 NORTH AVE
BURLINGTON, VT
ZIP 05408
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Facility Phone Number: 802 865-7822

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1962925560

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	47D2243555
LAB Type	Pharmacy
Facility Name	WALGREENS #19570
Street	1024 NORTH AVE
City	BURLINGTON
State	VT
ZIP	05408
Phone	802 865-7822
CertificateType	4
CertificateEffectiveDate	11/19/2023
CertificateExpirationDate	11/18/2025
FacilityType	Waiver

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