25D2038755 CLIA NUMBER - WALGREENS #09545

Laboratory Demographics

  • CLIA Code: 25D2038755
  • Facility Name: WALGREENS #09545
  • Facility Address: 120 W RAILROAD STREET
    LONG BEACH, MS
    ZIP 39560
  • Facility Phone: 228 575-4057
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHANH L. NGUYEN
  • NPI Number: 1114932357
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2038755
LAB Type Pharmacy
Facility Name WALGREENS #09545
Street 120 W RAILROAD STREET
City LONG BEACH
State MS
ZIP 39560
Phone 228 575-4057
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director KHANH L. NGUYEN

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