07D2218396 CLIA NUMBER - WALGREENS # 11919

Laboratory Demographics

  • CLIA Code: 07D2218396
  • Facility Name: WALGREENS # 11919
  • Facility Address: 1630 BOSTON TPKE
    COVENTRY, CT
    ZIP 06238
  • Facility Phone: 860 742-5389
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTEN WIESE
  • NPI Number: 1326371956
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2218396
LAB Type Pharmacy
Facility Name WALGREENS # 11919
Street 1630 BOSTON TPKE
City COVENTRY
State CT
ZIP 06238
Phone 860 742-5389
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/29/2025
Certificate Expiration Date 3/28/2027
Facility Type Pharmacy
Lab Director KRISTEN WIESE

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