20D2199894 CLIA NUMBER - WALGREENS #19908

Laboratory Demographics

  • CLIA Code: 20D2199894
  • Facility Name: WALGREENS #19908
  • Facility Address: 575 LISBON ST
    LISBON FALLS, ME
    ZIP 04252
  • Facility Phone: 207 353-4843
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASSANDRA LYONS
  • NPI Number: 1932624939
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2199894
LAB Type Pharmacy
Facility Name WALGREENS #19908
Street 575 LISBON ST
City LISBON FALLS
State ME
ZIP 04252
Phone 207 353-4843
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/12/2024
Certificate Expiration Date 11/11/2026
Facility Type Pharmacy
Lab Director CASSANDRA LYONS

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This page was last updated on: 3/20/2025