07D2221547 CLIA NUMBER - WALGREENS # 11533

Laboratory Demographics

  • CLIA Code: 07D2221547
  • Facility Name: WALGREENS # 11533
  • Facility Address: 1312 MANCHESTER RD
    GLASTONBURY, CT
    ZIP 06033
  • Facility Phone: 860 781-7073
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLE DUFAULT RPH
  • NPI Number: 1639492119
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2221547
LAB Type Pharmacy
Facility Name WALGREENS # 11533
Street 1312 MANCHESTER RD
City GLASTONBURY
State CT
ZIP 06033
Phone 860 781-7073
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director KYLE DUFAULT RPH

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