49D2032698 CLIA NUMBER - WALGREENS #11381

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Laboratory Demographics

CLIA Number: 49D2032698

Facility Name: WALGREENS #11381

Facility Address:
573 N MAIN STREET
KILMARNOCK, VA
ZIP 22482
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Facility Phone Number: 804 435-8890

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1184809584

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	49D2032698
LAB Type	Physician Office
Facility Name	WALGREENS #11381
Street	573 N MAIN STREET
City	KILMARNOCK
State	VA
ZIP	22482
Phone	804 435-8890
CertificateType	4
CertificateEffectiveDate	2/8/2023
CertificateExpirationDate	2/7/2025
FacilityType	Waiver

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