20D2200379 CLIA NUMBER - WALGREENS #19575

Laboratory Demographics

  • CLIA Code: 20D2200379
  • Facility Name: WALGREENS #19575
  • Facility Address: 28 MAYVILLE RD
    BETHEL, ME
    ZIP 04217
  • Facility Phone: 207 824-8085
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATELYN COLE
  • NPI Number: 1457877714
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2200379
LAB Type Pharmacy
Facility Name WALGREENS #19575
Street 28 MAYVILLE RD
City BETHEL
State ME
ZIP 04217
Phone 207 824-8085
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/16/2024
Certificate Expiration Date 11/15/2026
Facility Type Pharmacy
Lab Director KATELYN COLE

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