25D2037885 CLIA NUMBER - WALGREENS #05653

Laboratory Demographics

  • CLIA Code: 25D2037885
  • Facility Name: WALGREENS #05653
  • Facility Address: 3800 MARKET STREET
    PASCAGOULA, MS
    ZIP 39567
  • Facility Phone: 228 202-8215
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DENISE L. RAINEY
  • NPI Number: 1386659548
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2037885
LAB Type Pharmacy
Facility Name WALGREENS #05653
Street 3800 MARKET STREET
City PASCAGOULA
State MS
ZIP 39567
Phone 228 202-8215
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director DENISE L. RAINEY

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This page was last updated on: 6/4/2025