25D2027098 CLIA NUMBER - WALGREENS #11111

Laboratory Demographics

  • CLIA Code: 25D2027098
  • Facility Name: WALGREENS #11111
  • Facility Address: 1100 HWY 51
    MADISON, MS
    ZIP 39110
  • Facility Phone: 601 853-2088
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT J. ROGERS
  • NPI Number: 1922013184
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2027098
LAB Type Pharmacy
Facility Name WALGREENS #11111
Street 1100 HWY 51
City MADISON
State MS
ZIP 39110
Phone 601 853-2088
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director ROBERT J. ROGERS

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