20D2199668 CLIA NUMBER - WALGREENS #17484

Laboratory Demographics

  • CLIA Code: 20D2199668
  • Facility Name: WALGREENS #17484
  • Facility Address: 19 MAIN ST
    OAKLAND, ME
    ZIP 04963
  • Facility Phone: 207 465-2757
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH W. ERVIN
  • NPI Number: 1922523562
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199668
LAB Type Pharmacy
Facility Name WALGREENS #17484
Street 19 MAIN ST
City OAKLAND
State ME
ZIP 04963
Phone 207 465-2757
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/10/2024
Certificate Expiration Date 11/9/2026
Facility Type Pharmacy
Lab Director JOSEPH W. ERVIN

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