01D2221308 CLIA NUMBER - WALGREENS #10523

Laboratory Demographics

  • CLIA Code: 01D2221308
  • Facility Name: WALGREENS #10523
  • Facility Address: 1613 GLENN BLVD SW
    FORT PAYNE, AL
    ZIP 35968
  • Facility Phone: 256 845-0128
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LORI L. CAMP
  • NPI Number: 1124150321
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2221308
LAB Type Pharmacy
Facility Name WALGREENS #10523
Street 1613 GLENN BLVD SW
City FORT PAYNE
State AL
ZIP 35968
Phone 256 845-0128
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director LORI L. CAMP

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