20D2291351 CLIA NUMBER - WALGREENS 19606

Laboratory Demographics

  • CLIA Code: 20D2291351
  • Facility Name: WALGREENS 19606
  • Facility Address: 464 MAIN ST
    SPRINGVALE, ME
    ZIP 04083
  • Facility Phone: 207 324-1222
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONNIE C. OLISE
  • NPI Number: 1891219960
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 20D2291351
LAB Type Pharmacy
Facility Name WALGREENS 19606
Street 464 MAIN ST
City SPRINGVALE
State ME
ZIP 04083
Phone 207 324-1222
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/10/2025
Certificate Expiration Date 10/9/2027
Facility Type Pharmacy
Lab Director TONNIE C. OLISE

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