25D2037849 CLIA NUMBER - WALGREENS #04172

Laboratory Demographics

  • CLIA Code: 25D2037849
  • Facility Name: WALGREENS #04172
  • Facility Address: 2405 PASS ROAD
    BILOXI, MS
    ZIP 39531
  • Facility Phone: 228 388-3458
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DESIREA D. QUEEN
  • NPI Number: 1669487823
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037849
LAB Type Pharmacy
Facility Name WALGREENS #04172
Street 2405 PASS ROAD
City BILOXI
State MS
ZIP 39531
Phone 228 388-3458
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 DESIREA D. QUEEN

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