07D2218398 CLIA NUMBER - WALGREENS # 12058

Laboratory Demographics

  • CLIA Code: 07D2218398
  • Facility Name: WALGREENS # 12058
  • Facility Address: 1093 NORTH MAIN ST
    DAYVILLE, CT
    ZIP 06241
  • Facility Phone: 860 774-0490
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: COSTANZO JR CAPARRELLI
  • NPI Number: 1548593650
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2218398
LAB Type Pharmacy
Facility Name WALGREENS # 12058
Street 1093 NORTH MAIN ST
City DAYVILLE
State CT
ZIP 06241
Phone 860 774-0490
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 COSTANZO JR CAPARRELLI

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