51D2069061 CLIA NUMBER - WALGREENS # 15189

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Laboratory Demographics

CLIA Number: 51D2069061

Facility Name: WALGREENS # 15189

Facility Address:
40 FLOWING SPRINGS WAY
CHARLES TOWN, WV
ZIP 25414
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Facility Phone Number: 304 724-0002

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1144665373

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	51D2069061
LAB Type	Pharmacy
Facility Name	WALGREENS # 15189
Street	40 FLOWING SPRINGS WAY
City	CHARLES TOWN
State	WV
ZIP	25414
Phone	304 724-0002
CertificateType	4
CertificateEffectiveDate	4/9/2023
CertificateExpirationDate	4/8/2025
FacilityType	Waiver

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