07D2289683 CLIA NUMBER - WALGREENS 17500

Laboratory Demographics

  • CLIA Code: 07D2289683
  • Facility Name: WALGREENS 17500
  • Facility Address: 203 KENNEDY DR
    PUTNAM, CT
    ZIP 06260
  • Facility Phone: 860 963-7230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHA AL-AMIR PHARM D
  • NPI Number: 1255855425
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 07D2289683
LAB Type Pharmacy
Facility Name WALGREENS 17500
Street 203 KENNEDY DR
City PUTNAM
State CT
ZIP 06260
Phone 860 963-7230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/14/2025
Certificate Expiration Date 9/13/2027
Facility Type Pharmacy
Lab Director RACHA AL-AMIR PHARM D

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