20D2199467 CLIA NUMBER - WALGREENS #17141

Laboratory Demographics

  • CLIA Code: 20D2199467
  • Facility Name: WALGREENS #17141
  • Facility Address: 566 UNION STREET
    BANGOR, ME
    ZIP 04401
  • Facility Phone: 207 262-5885
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KENT BRIDGES
  • NPI Number: 1700300407
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199467
LAB Type Pharmacy
Facility Name WALGREENS #17141
Street 566 UNION STREET
City BANGOR
State ME
ZIP 04401
Phone 207 262-5885
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 KENT BRIDGES

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