20D2199387 CLIA NUMBER - WALGREENS #19802

Laboratory Demographics

  • CLIA Code: 20D2199387
  • Facility Name: WALGREENS #19802
  • Facility Address: 430 SABATTUS STREET
    LEWISTON, ME
    ZIP 04240
  • Facility Phone: 207 783-2013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOMENJAN ABDULLAYOF
  • NPI Number: 1548786734
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199387
LAB Type Pharmacy
Facility Name WALGREENS #19802
Street 430 SABATTUS STREET
City LEWISTON
State ME
ZIP 04240
Phone 207 783-2013
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 MOMENJAN ABDULLAYOF

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