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51D2233758 CLIA NUMBER - WALGREENS #19094

Laboratory Demographics

CLIA Number: 51D2233758

Facility Name: WALGREENS #19094

Facility Address:
208 SOUTH PIKE STREET
SHINNSTON, WV
ZIP 26431
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Facility Phone Number: 304 592-8003

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1669998241

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 51D2233758
LAB Type Pharmacy
Facility Name WALGREENS #19094
Street 208 SOUTH PIKE STREET
City SHINNSTON
State WV
ZIP 26431
Phone 304 592-8003
CertificateType 4
CertificateEffectiveDate 8/25/2023
CertificateExpirationDate 8/24/2025
FacilityType Waiver

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