20D2199727 CLIA NUMBER - WALGREENS #19162

Laboratory Demographics

  • CLIA Code: 20D2199727
  • Facility Name: WALGREENS #19162
  • Facility Address: 698 MINOT AVENUE
    AUBURN, ME
    ZIP 04210
  • Facility Phone: 207 786-5330
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA M. TARDIF
  • NPI Number: 1164947487
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199727
LAB Type Pharmacy
Facility Name WALGREENS #19162
Street 698 MINOT AVENUE
City AUBURN
State ME
ZIP 04210
Phone 207 786-5330
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 JOSHUA M. TARDIF

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