01D2216499 CLIA NUMBER - WALGREENS #13793

Laboratory Demographics

  • CLIA Code: 01D2216499
  • Facility Name: WALGREENS #13793
  • Facility Address: 12010 COUNTY LINE ROAD
    MADISON, AL
    ZIP 35756
  • Facility Phone: 256 230-6345
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SOOYOUN KANG
  • NPI Number: 1174874267
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2216499
LAB Type Pharmacy
Facility Name WALGREENS #13793
Street 12010 COUNTY LINE ROAD
City MADISON
State AL
ZIP 35756
Phone 256 230-6345
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/12/2025
Certificate Expiration Date 3/11/2027
Facility Type Pharmacy
Lab Director SOOYOUN KANG

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This page was last updated on: 9/29/2025