20D2198982 CLIA NUMBER - WALGREENS #10428

Laboratory Demographics

  • CLIA Code: 20D2198982
  • Facility Name: WALGREENS #10428
  • Facility Address: 741 ROOSEVELT TRAIL
    WINDHAM, ME
    ZIP 04062
  • Facility Phone: 207 893-2562
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES R. CHAREST
  • NPI Number: 1093852618
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2198982
LAB Type Pharmacy
Facility Name WALGREENS #10428
Street 741 ROOSEVELT TRAIL
City WINDHAM
State ME
ZIP 04062
Phone 207 893-2562
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/5/2024
Certificate Expiration Date 11/4/2026
Facility Type Pharmacy
Lab Director JAMES R. CHAREST

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