20D2199392 CLIA NUMBER - WALGREENS #19789

Laboratory Demographics

  • CLIA Code: 20D2199392
  • Facility Name: WALGREENS #19789
  • Facility Address: 62 W GRAY ROAD
    GRAY, ME
    ZIP 04039
  • Facility Phone: 207 657-2333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSIE SHIERS
  • NPI Number: 1629593694
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199392
LAB Type Pharmacy
Facility Name WALGREENS #19789
Street 62 W GRAY ROAD
City GRAY
State ME
ZIP 04039
Phone 207 657-2333
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 JESSIE SHIERS

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