20D2199501 CLIA NUMBER - WALGREENS #19241

Laboratory Demographics

  • CLIA Code: 20D2199501
  • Facility Name: WALGREENS #19241
  • Facility Address: 84 E MAIN STREET
    FORT KENT, ME
    ZIP 04743
  • Facility Phone: 207 834-5444
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CURTIS B. CYR
  • NPI Number: 1750806014
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199501
LAB Type Pharmacy
Facility Name WALGREENS #19241
Street 84 E MAIN STREET
City FORT KENT
State ME
ZIP 04743
Phone 207 834-5444
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 CURTIS B. CYR

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