51D2062124 CLIA NUMBER - WALGREENS # 10876

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Laboratory Demographics

CLIA Number: 51D2062124

Facility Name: WALGREENS # 10876

Facility Address:
323 SOUTH WALKER STREET
PRINCETON, WV
ZIP 24740
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Facility Phone Number: 304 431-4967

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1245407949

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	51D2062124
LAB Type	Pharmacy
Facility Name	WALGREENS # 10876
Street	323 SOUTH WALKER STREET
City	PRINCETON
State	WV
ZIP	24740
Phone	304 431-4967
CertificateType	4
CertificateEffectiveDate	4/7/2023
CertificateExpirationDate	4/6/2025
FacilityType	Waiver

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