07D2186461 CLIA NUMBER - WALGREENS # 02858

Laboratory Demographics

  • CLIA Code: 07D2186461
  • Facility Name: WALGREENS # 02858
  • Facility Address: 633 WASHINGTON STREET
    MIDDLETOWN, CT
    ZIP 06457
  • Facility Phone: 860 346-7628
  • Facility Type: Other - COVID 19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: WAFAA EWIS
  • NPI Number: 1346567096
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2186461
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS # 02858
Street 633 WASHINGTON STREET
City MIDDLETOWN
State CT
ZIP 06457
Phone 860 346-7628
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Other - COVID 19 TEST SITE
Lab Director WAFAA EWIS

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