25D2037847 CLIA NUMBER - WALGREENS #09037

Laboratory Demographics

  • CLIA Code: 25D2037847
  • Facility Name: WALGREENS #09037
  • Facility Address: 419 N 16TH AVENUE
    LAUREL, MS
    ZIP 39440
  • Facility Phone: 601 425-5808
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY L. RUSSELL
  • NPI Number: 1548275704
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037847
LAB Type Pharmacy
Facility Name WALGREENS #09037
Street 419 N 16TH AVENUE
City LAUREL
State MS
ZIP 39440
Phone 601 425-5808
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/24/2023
Certificate Expiration Date 11/23/2025
Facility Type Pharmacy
Lab Director ANTHONY L. RUSSELL

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