20D2199737 CLIA NUMBER - WALGREENS #17964

Laboratory Demographics

  • CLIA Code: 20D2199737
  • Facility Name: WALGREENS #17964
  • Facility Address: 365 MAIN ST
    DAMARISCOTTA, ME
    ZIP 04543
  • Facility Phone: 207 563-3506
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMILY C. WILSON
  • NPI Number: 1427573062
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199737
LAB Type Pharmacy
Facility Name WALGREENS #17964
Street 365 MAIN ST
City DAMARISCOTTA
State ME
ZIP 04543
Phone 207 563-3506
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 EMILY C. WILSON

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