25D2037855 CLIA NUMBER - WALGREENS #12929

Laboratory Demographics

  • CLIA Code: 25D2037855
  • Facility Name: WALGREENS #12929
  • Facility Address: 804 SPRING ST
    WAYNESBORO, MS
    ZIP 39367
  • Facility Phone: 601 735-2513
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDI L. FREEMAN
  • NPI Number: 1013168053
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037855
LAB Type Pharmacy
Facility Name WALGREENS #12929
Street 804 SPRING ST
City WAYNESBORO
State MS
ZIP 39367
Phone 601 735-2513
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/18/2025
Certificate Expiration Date 8/17/2027
Facility Type Pharmacy
Lab Director BRANDI L. FREEMAN

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