25D2037840 CLIA NUMBER - WALGREENS #12536

Laboratory Demographics

  • CLIA Code: 25D2037840
  • Facility Name: WALGREENS #12536
  • Facility Address: 219 WOOLAND DRIVE NORTH
    FOREST, MS
    ZIP 39074
  • Facility Phone: 601 469-3393
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOHANA MCDONALD
  • NPI Number: 1881839421
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 25D2037840
LAB Type Pharmacy
Facility Name WALGREENS #12536
Street 219 WOOLAND DRIVE NORTH
City FOREST
State MS
ZIP 39074
Phone 601 469-3393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director JOHANA MCDONALD

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