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51D2234582 CLIA NUMBER - WALGREENS #17274

Laboratory Demographics

CLIA Number: 51D2234582

Facility Name: WALGREENS #17274

Facility Address:
201 ROOSEVELT BLVD
ELEANOR, WV
ZIP 25070
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Facility Phone Number: 304 586-9064

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1992220628

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 51D2234582
LAB Type Pharmacy
Facility Name WALGREENS #17274
Street 201 ROOSEVELT BLVD
City ELEANOR
State WV
ZIP 25070
Phone 304 586-9064
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