25D2013343 CLIA NUMBER - WALGREENS #05307

Laboratory Demographics

  • CLIA Code: 25D2013343
  • Facility Name: WALGREENS #05307
  • Facility Address: 6130 US HWY 49
    HATTIESBURG, MS
    ZIP 39401
  • Facility Phone: 601 545-6959
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BARTON K. HUDSON
  • NPI Number: 1659386811
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2013343
LAB Type Pharmacy
Facility Name WALGREENS #05307
Street 6130 US HWY 49
City HATTIESBURG
State MS
ZIP 39401
Phone 601 545-6959
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/26/2023
Certificate Expiration Date 10/25/2025
Facility Type Pharmacy
Lab Director BARTON K. HUDSON

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