07D2223883 CLIA NUMBER - WALGREENS STORE # 09521

Laboratory Demographics

  • CLIA Code: 07D2223883
  • Facility Name: WALGREENS STORE # 09521
  • Facility Address: 1000 PARK AVE
    BRIDGEPORT, CT
    ZIP 06604
  • Facility Phone: 203 696-0127
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASEY VENTIMIGLIA
  • NPI Number: 1710096318
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2223883
LAB Type Pharmacy
Facility Name WALGREENS STORE # 09521
Street 1000 PARK AVE
City BRIDGEPORT
State CT
ZIP 06604
Phone 203 696-0127
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director CASEY VENTIMIGLIA

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