25D2035651 CLIA NUMBER - WALGREENS #12308

Laboratory Demographics

  • CLIA Code: 25D2035651
  • Facility Name: WALGREENS #12308
  • Facility Address: 5148 HIGHWAY 51 N
    SENATOBIA, MS
    ZIP 38668
  • Facility Phone: 662 562-9366
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KIMBERLY S. BRADLEY
  • NPI Number: 1386800035
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2035651
LAB Type Pharmacy
Facility Name WALGREENS #12308
Street 5148 HIGHWAY 51 N
City SENATOBIA
State MS
ZIP 38668
Phone 662 562-9366
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/20/2025
Certificate Expiration Date 4/19/2027
Facility Type Pharmacy
Lab Director KIMBERLY S. BRADLEY

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