49D2014573 CLIA NUMBER - WALGREENS #04616

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Laboratory Demographics

CLIA Number: 49D2014573

Facility Name: WALGREENS #04616

Facility Address:
700 FREDERICK BOULEVARD
PORTSMOUTH, VA
ZIP 23707
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Facility Phone Number: 757 391-9123

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1790055945

Taxonomy: 3336C0003X - Pharmacy
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.

CLIA Record

Field Name	Field Value
CLIA Number	49D2014573
LAB Type	Pharmacy
Facility Name	WALGREENS #04616
Street	700 FREDERICK BOULEVARD
City	PORTSMOUTH
State	VA
ZIP	23707
Phone	757 391-9123
CertificateType	4
CertificateEffectiveDate	6/9/2023
CertificateExpirationDate	6/8/2025
FacilityType	Waiver

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