07D2238696 CLIA NUMBER - WALGREENS # 17433

Laboratory Demographics

  • CLIA Code: 07D2238696
  • Facility Name: WALGREENS # 17433
  • Facility Address: 84 WEST STAFFORD RD
    STAFFORD SPRINGS, CT
    ZIP 06076
  • Facility Phone: 860 684-9555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JIM ROSE PHARM-D
  • NPI Number: 1467975482
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2238696
LAB Type Pharmacy
Facility Name WALGREENS # 17433
Street 84 WEST STAFFORD RD
City STAFFORD SPRINGS
State CT
ZIP 06076
Phone 860 684-9555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/6/2025
Certificate Expiration Date 10/5/2027
Facility Type Pharmacy
Lab Director JIM ROSE PHARM-D

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