20D2199390 CLIA NUMBER - WALGREENS #19330

Laboratory Demographics

  • CLIA Code: 20D2199390
  • Facility Name: WALGREENS #19330
  • Facility Address: 15 SHAPLEIGH
    KITTERY, ME
    ZIP 03904
  • Facility Phone: 207 438-9079
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BROOK E. HENDERSON
  • NPI Number: 1831613967
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199390
LAB Type Pharmacy
Facility Name WALGREENS #19330
Street 15 SHAPLEIGH
City KITTERY
State ME
ZIP 03904
Phone 207 438-9079
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 BROOK E. HENDERSON

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