07D2244558 CLIA NUMBER - WALGREENS # 10261

Laboratory Demographics

  • CLIA Code: 07D2244558
  • Facility Name: WALGREENS # 10261
  • Facility Address: 180 MAIN ST
    DEEP RIVER, CT
    ZIP 06417
  • Facility Phone: 860 526-8052
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GEORGIOS D. GIAMBANIS RPH
  • NPI Number: 1578739439
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2244558
LAB Type Pharmacy
Facility Name WALGREENS # 10261
Street 180 MAIN ST
City DEEP RIVER
State CT
ZIP 06417
Phone 860 526-8052
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/2/2023
Certificate Expiration Date 12/1/2025
Facility Type Pharmacy
Lab Director GEORGIOS D. GIAMBANIS RPH

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