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47D2287735 CLIA NUMBER - WALGREENS 17485

Laboratory Demographics

CLIA Number: 47D2287735

Facility Name: WALGREENS 17485

Facility Address:
321 MAIN ST, STE 1
WINOOSKI, VT
ZIP 05404
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Facility Phone Number: 802 655-2444

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1376066944

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 47D2287735
LAB Type Pharmacy
Facility Name WALGREENS 17485
Street 321 MAIN ST, STE 1
City WINOOSKI
State VT
ZIP 05404
Phone 802 655-2444
CertificateType 4
CertificateEffectiveDate 8/17/2023
CertificateExpirationDate 8/16/2025
FacilityType Waiver

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