25D2037823 CLIA NUMBER - WALGREENS #13609

Laboratory Demographics

  • CLIA Code: 25D2037823
  • Facility Name: WALGREENS #13609
  • Facility Address: 1028 HWY 98
    COLUMBIA, MS
    ZIP 39429
  • Facility Phone: 601 736-0368
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDI WISE
  • NPI Number: 1770873226
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037823
LAB Type Pharmacy
Facility Name WALGREENS #13609
Street 1028 HWY 98
City COLUMBIA
State MS
ZIP 39429
Phone 601 736-0368
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director BRANDI WISE

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