25D2037878 CLIA NUMBER - WALGREENS #10290

Laboratory Demographics

  • CLIA Code: 25D2037878
  • Facility Name: WALGREENS #10290
  • Facility Address: 1505 HIGHWAY 43 S
    PICAYUNE, MS
    ZIP 39466
  • Facility Phone: 601 889-9509
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANYELLE KIMBLE
  • NPI Number: 1174531065
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037878
LAB Type Pharmacy
Facility Name WALGREENS #10290
Street 1505 HIGHWAY 43 S
City PICAYUNE
State MS
ZIP 39466
Phone 601 889-9509
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 DANYELLE KIMBLE

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