50D2061032 CLIA NUMBER - WALGREENS #12168

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Laboratory Demographics

CLIA Number: 50D2061032

Facility Name: WALGREENS #12168

Facility Address:
3929 KITSAP WAY
BREMERTON, WA
ZIP 98312
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Facility Phone Number: 360 917-1041

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1003047846

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	50D2061032
LAB Type	Pharmacy
Facility Name	WALGREENS #12168
Street	3929 KITSAP WAY
City	BREMERTON
State	WA
ZIP	98312
Phone	360 917-1041
CertificateType	4
CertificateEffectiveDate	12/18/2020
CertificateExpirationDate	4/4/2028
FacilityType	Waiver

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