50D2063082 CLIA NUMBER - WALGREENS #6307

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Laboratory Demographics

CLIA Number: 50D2063082

Facility Name: WALGREENS #6307

Facility Address:
10200 MUKILTEO SPEEDWAY
MUKILTEO, WA
ZIP 98275
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Facility Phone Number: 425 315-9213

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1740295716

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	50D2063082
LAB Type	Pharmacy
Facility Name	WALGREENS #6307
Street	10200 MUKILTEO SPEEDWAY
City	MUKILTEO
State	WA
ZIP	98275
Phone	425 315-9213
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