01D2241778 CLIA NUMBER - WALGREENS #17955

Laboratory Demographics

  • CLIA Code: 01D2241778
  • Facility Name: WALGREENS #17955
  • Facility Address: 3206 15TH ST
    TUSCALOOSA, AL
    ZIP 35401
  • Facility Phone: 205 349-1330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NEUMANSHEL F. INGRAM
  • NPI Number: 1326561424
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2241778
LAB Type Pharmacy
Facility Name WALGREENS #17955
Street 3206 15TH ST
City TUSCALOOSA
State AL
ZIP 35401
Phone 205 349-1330
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/2/2023
Certificate Expiration Date 11/1/2025
Facility Type Pharmacy
Lab Director NEUMANSHEL F. INGRAM

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