01D2291471 CLIA NUMBER - WALGREENS 09683

Laboratory Demographics

  • CLIA Code: 01D2291471
  • Facility Name: WALGREENS 09683
  • Facility Address: 100 N AIRPORT RD
    JASPER, AL
    ZIP 35504
  • Facility Phone: 205 221-3150
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DR. WESLEY E. FRYDENDAHL
  • NPI Number: 1457366726
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2291471
LAB Type Pharmacy
Facility Name WALGREENS 09683
Street 100 N AIRPORT RD
City JASPER
State AL
ZIP 35504
Phone 205 221-3150
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type Pharmacy
Lab Director DR. WESLEY E. FRYDENDAHL

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