25D2020511 CLIA NUMBER - WALGREENS #15485

Laboratory Demographics

  • CLIA Code: 25D2020511
  • Facility Name: WALGREENS #15485
  • Facility Address: 1583 E COUNTY LINE ROAD
    JACKSON, MS
    ZIP 39211
  • Facility Phone: 601 952-2979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAGROOP KAUR
  • NPI Number: 1831104090
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2020511
LAB Type Pharmacy
Facility Name WALGREENS #15485
Street 1583 E COUNTY LINE ROAD
City JACKSON
State MS
ZIP 39211
Phone 601 952-2979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director JAGROOP KAUR

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