07D2224996 CLIA NUMBER - WALGREENS # 09432

Laboratory Demographics

  • CLIA Code: 07D2224996
  • Facility Name: WALGREENS # 09432
  • Facility Address: 2 SHAKER RD
    ENFIELD, CT
    ZIP 06082
  • Facility Phone: 860 253-0463
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIA D. BENTO PHARM-D
  • NPI Number: 1063550473
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2224996
LAB Type Pharmacy
Facility Name WALGREENS # 09432
Street 2 SHAKER RD
City ENFIELD
State CT
ZIP 06082
Phone 860 253-0463
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/18/2025
Certificate Expiration Date 5/17/2027
Facility Type Pharmacy
Lab Director MARIA D. BENTO PHARM-D

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