25D2037828 CLIA NUMBER - WALGREENS #10805

Laboratory Demographics

  • CLIA Code: 25D2037828
  • Facility Name: WALGREENS #10805
  • Facility Address: 1628 SIMPSON HWY 49
    MAGEE, MS
    ZIP 39111
  • Facility Phone: 601 849-4959
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSICA E. TUCKER
  • NPI Number: 1295925428
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037828
LAB Type Pharmacy
Facility Name WALGREENS #10805
Street 1628 SIMPSON HWY 49
City MAGEE
State MS
ZIP 39111
Phone 601 849-4959
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director JESSICA E. TUCKER

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