49D2024093 CLIA NUMBER - WALGREENS #03685

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Laboratory Demographics

CLIA Number: 49D2024093

Facility Name: WALGREENS #03685

Facility Address:
5802 W BROAD STREET
RICHMOND, VA
ZIP 23230
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Facility Phone Number: 804 288-3191

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1912912957

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	49D2024093
LAB Type	Pharmacy
Facility Name	WALGREENS #03685
Street	5802 W BROAD STREET
City	RICHMOND
State	VA
ZIP	23230
Phone	804 288-3191
CertificateType	4
CertificateEffectiveDate	12/21/2022
CertificateExpirationDate	12/20/2024
FacilityType	Waiver

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