20D2199396 CLIA NUMBER - WALGREENS #17455

Laboratory Demographics

  • CLIA Code: 20D2199396
  • Facility Name: WALGREENS #17455
  • Facility Address: 223 NORTH STREET
    CALAIS, ME
    ZIP 04619
  • Facility Phone: 207 454-2262
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON MICHAUD
  • NPI Number: 1982129516
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199396
LAB Type Pharmacy
Facility Name WALGREENS #17455
Street 223 NORTH STREET
City CALAIS
State ME
ZIP 04619
Phone 207 454-2262
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 JASON MICHAUD

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