25D2037836 CLIA NUMBER - WALGREENS #05098

Laboratory Demographics

  • CLIA Code: 25D2037836
  • Facility Name: WALGREENS #05098
  • Facility Address: 955 N STATE STREET
    JACKSON, MS
    ZIP 39201
  • Facility Phone: 601 969-5388
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA S. BROWN
  • NPI Number: 1568477727
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2037836
LAB Type Pharmacy
Facility Name WALGREENS #05098
Street 955 N STATE STREET
City JACKSON
State MS
ZIP 39201
Phone 601 969-5388
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director JOSHUA S. BROWN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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