50D2013504 CLIA NUMBER - WALGREENS #5571

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Laboratory Demographics

CLIA Number: 50D2013504

Facility Name: WALGREENS #5571

Facility Address:
1510 SW COOPER POINT RD SW
OLYMPIA, WA
ZIP 98502
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Facility Phone Number: 360 570-8008

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1104831171

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	50D2013504
LAB Type	Pharmacy
Facility Name	WALGREENS #5571
Street	1510 SW COOPER POINT RD SW
City	OLYMPIA
State	WA
ZIP	98502
Phone	360 570-8008
CertificateType	4
CertificateEffectiveDate	12/15/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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