20D2198812 CLIA NUMBER - WALGREENS #17156

Laboratory Demographics

  • CLIA Code: 20D2198812
  • Facility Name: WALGREENS #17156
  • Facility Address: 210 MAIN STREET
    WATERVILLE, ME
    ZIP 04901
  • Facility Phone: 207 877-9004
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUDHIR DABBAS
  • NPI Number: 1962926683
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2198812
LAB Type Pharmacy
Facility Name WALGREENS #17156
Street 210 MAIN STREET
City WATERVILLE
State ME
ZIP 04901
Phone 207 877-9004
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 SUDHIR DABBAS

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