07D2224998 CLIA NUMBER - WALGREENS # 09612

Laboratory Demographics

  • CLIA Code: 07D2224998
  • Facility Name: WALGREENS # 09612
  • Facility Address: 700 BRIDGEPORT AVE
    SHELTON, CT
    ZIP 06484
  • Facility Phone: 203 225-0296
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARVEY OKSANA
  • NPI Number: 1255350815
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2224998
LAB Type Pharmacy
Facility Name WALGREENS # 09612
Street 700 BRIDGEPORT AVE
City SHELTON
State CT
ZIP 06484
Phone 203 225-0296
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 HARVEY OKSANA

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