20D2199383 CLIA NUMBER - WALGREENS #19678

Laboratory Demographics

  • CLIA Code: 20D2199383
  • Facility Name: WALGREENS #19678
  • Facility Address: 279 MAIN STREET
    SOUTH PORTLAND, ME
    ZIP 04106
  • Facility Phone: 207 741-2260
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARTHA E. FLYNN
  • NPI Number: 1528582608
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199383
LAB Type Pharmacy
Facility Name WALGREENS #19678
Street 279 MAIN STREET
City SOUTH PORTLAND
State ME
ZIP 04106
Phone 207 741-2260
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2024
Certificate Expiration Date 11/8/2026
Facility Type Pharmacy
Lab Director MARTHA E. FLYNN

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