20D2198867 CLIA NUMBER - WALGREENS #11285

Laboratory Demographics

  • CLIA Code: 20D2198867
  • Facility Name: WALGREENS #11285
  • Facility Address: 706 BROADWAY
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 262-0190
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEREK S. JOSEPH
  • NPI Number: 1770758898
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2198867
LAB Type Pharmacy
Facility Name WALGREENS #11285
Street 706 BROADWAY
City BANGOR
State ME
ZIP 04401
Phone 207 262-0190
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 DEREK S. JOSEPH

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