25D2013341 CLIA NUMBER - WALGREENS #12822

Laboratory Demographics

  • CLIA Code: 25D2013341
  • Facility Name: WALGREENS #12822
  • Facility Address: 1790 W GOVERNMENT STREET
    BRANDON, MS
    ZIP 39042
  • Facility Phone: 601 825-3473
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER G. MCLAURIN
  • NPI Number: 1831331230
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2013341
LAB Type Pharmacy
Facility Name WALGREENS #12822
Street 1790 W GOVERNMENT STREET
City BRANDON
State MS
ZIP 39042
Phone 601 825-3473
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/16/2025
Certificate Expiration Date 6/15/2027
Facility Type Pharmacy
Lab Director CHRISTOPHER G. MCLAURIN

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