20D2198783 CLIA NUMBER - WALGREENS #17159

Laboratory Demographics

  • CLIA Code: 20D2198783
  • Facility Name: WALGREENS #17159
  • Facility Address: 7 PORTLAND STREET
    RUMFORD, ME
    ZIP 04276
  • Facility Phone: 207 364-2969
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KAREN B. WOLFSON
  • NPI Number: 1457875189
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2198783
LAB Type Pharmacy
Facility Name WALGREENS #17159
Street 7 PORTLAND STREET
City RUMFORD
State ME
ZIP 04276
Phone 207 364-2969
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/4/2024
Certificate Expiration Date 11/3/2026
Facility Type Pharmacy
Lab Director KAREN B. WOLFSON

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