07D2289110 CLIA NUMBER - WALGREENS #19414

Laboratory Demographics

  • CLIA Code: 07D2289110
  • Facility Name: WALGREENS #19414
  • Facility Address: 90 HALLS ROAD
    OLD LYME, CT
    ZIP 06371
  • Facility Phone: 860 434-8111
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHN L. CARFI
  • NPI Number: 1740703511
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2289110
LAB Type Pharmacy
Facility Name WALGREENS #19414
Street 90 HALLS ROAD
City OLD LYME
State CT
ZIP 06371
Phone 860 434-8111
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/6/2025
Certificate Expiration Date 9/5/2027
Facility Type Pharmacy
Lab Director JOHN L. CARFI

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