14D2034858 CLIA NUMBER - WALGREENS #07236

Laboratory Demographics

  • CLIA Code: 14D2034858
  • Facility Name: WALGREENS #07236
  • Facility Address: 225 N ELM ST
    CENTRALIA, IL
    ZIP 62801
  • Facility Phone: 618 533-5395
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRENDA S. ALLEN
  • NPI Number: 1477568681
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2034858
LAB Type Pharmacy
Facility Name WALGREENS #07236
Street 225 N ELM ST
City CENTRALIA
State IL
ZIP 62801
Phone 618 533-5395
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director BRENDA S. ALLEN

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This page was last updated on: 6/4/2025