20D2200415 CLIA NUMBER - WALGREENS #17450

Laboratory Demographics

  • CLIA Code: 20D2200415
  • Facility Name: WALGREENS #17450
  • Facility Address: 226 PARKER FARM RD
    WEST BUXTON, ME
    ZIP 04093
  • Facility Phone: 207 727-5139
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL E. TYSON
  • NPI Number: 1831614460
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2200415
LAB Type Pharmacy
Facility Name WALGREENS #17450
Street 226 PARKER FARM RD
City WEST BUXTON
State ME
ZIP 04093
Phone 207 727-5139
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 RACHEL E. TYSON

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