25D2029477 CLIA NUMBER - WALGREENS #09896

Laboratory Demographics

  • CLIA Code: 25D2029477
  • Facility Name: WALGREENS #09896
  • Facility Address: 301 N DAVIS AVENUE
    CLEVELAND, MS
    ZIP 38732
  • Facility Phone: 662 846-5781
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAKEISHA HAYGOOD
  • NPI Number: 1932114170
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2029477
LAB Type Pharmacy
Facility Name WALGREENS #09896
Street 301 N DAVIS AVENUE
City CLEVELAND
State MS
ZIP 38732
Phone 662 846-5781
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Pharmacy
Lab Director MAKEISHA HAYGOOD

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