20D2198825 CLIA NUMBER - WALGREENS #11545

Laboratory Demographics

  • CLIA Code: 20D2198825
  • Facility Name: WALGREENS #11545
  • Facility Address: 437 WILSON STREET
    BREWER, ME
    ZIP 04412
  • Facility Phone: 207 991-9679
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK P. RICHARDSON
  • NPI Number: 1609049998
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2198825
LAB Type Pharmacy
Facility Name WALGREENS #11545
Street 437 WILSON STREET
City BREWER
State ME
ZIP 04412
Phone 207 991-9679
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 PATRICK P. RICHARDSON

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