01D2292677 CLIA NUMBER - WALGREENS 07404

Laboratory Demographics

  • CLIA Code: 01D2292677
  • Facility Name: WALGREENS 07404
  • Facility Address: 2041 E MAIN ST
    DOTHAN, AL
    ZIP 36301
  • Facility Phone: 334 712-6638
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA T. NELLUMS
  • NPI Number: 1609881960
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 01D2292677
LAB Type Pharmacy
Facility Name WALGREENS 07404
Street 2041 E MAIN ST
City DOTHAN
State AL
ZIP 36301
Phone 334 712-6638
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2023
Certificate Expiration Date 10/26/2025
Facility Type Pharmacy
Lab Director JESSICA T. NELLUMS

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