01D2230862 CLIA NUMBER - WALGREENS #17739

Laboratory Demographics

  • CLIA Code: 01D2230862
  • Facility Name: WALGREENS #17739
  • Facility Address: 25801 PERDIDO BEACH BOULEVARD
    ORANGE BEACH, AL
    ZIP 36561
  • Facility Phone: 251 981-7019
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEANNA G. BULMAN
  • NPI Number: 1053834424
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2230862
LAB Type Pharmacy
Facility Name WALGREENS #17739
Street 25801 PERDIDO BEACH BOULEVARD
City ORANGE BEACH
State AL
ZIP 36561
Phone 251 981-7019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/28/2023
Certificate Expiration Date 7/27/2025
Facility Type Pharmacy
Lab Director JEANNA G. BULMAN

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This page was last updated on: 6/4/2025