25D2035649 CLIA NUMBER - WALGREENS #10706

Laboratory Demographics

  • CLIA Code: 25D2035649
  • Facility Name: WALGREENS #10706
  • Facility Address: 950 E COMMERCE ST
    HERNANDO, MS
    ZIP 38632
  • Facility Phone: 662 429-3349
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW WYATT
  • NPI Number: 1760640585
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2035649
LAB Type Pharmacy
Facility Name WALGREENS #10706
Street 950 E COMMERCE ST
City HERNANDO
State MS
ZIP 38632
Phone 662 429-3349
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director ANDREW WYATT

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