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51D2234528 CLIA NUMBER - WALGREENS #18404

Laboratory Demographics

CLIA Number: 51D2234528

Facility Name: WALGREENS #18404

Facility Address:
1250 KANAWHA AVE
RAINELLE, WV
ZIP 25962
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Facility Phone Number: 304 438-9204

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1841716404

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 51D2234528
LAB Type Pharmacy
Facility Name WALGREENS #18404
Street 1250 KANAWHA AVE
City RAINELLE
State WV
ZIP 25962
Phone 304 438-9204
CertificateType 4
CertificateEffectiveDate 9/1/2023
CertificateExpirationDate 8/31/2025
FacilityType Waiver

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