20D2288900 CLIA NUMBER - WALGREENS 18403

Laboratory Demographics

  • CLIA Code: 20D2288900
  • Facility Name: WALGREENS 18403
  • Facility Address: 119 BRIDGTON ROAD
    FRYEBURG, ME
    ZIP 04037
  • Facility Phone: 207 935-2045
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JONATHAN P. VIOLETTE
  • NPI Number: 1699290056
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2288900
LAB Type Pharmacy
Facility Name WALGREENS 18403
Street 119 BRIDGTON ROAD
City FRYEBURG
State ME
ZIP 04037
Phone 207 935-2045
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Pharmacy
Lab Director JONATHAN P. VIOLETTE

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