25D2039671 CLIA NUMBER - WALGREENS #10321

Laboratory Demographics

  • CLIA Code: 25D2039671
  • Facility Name: WALGREENS #10321
  • Facility Address: 3348 HWY 90
    WAVELAND, MS
    ZIP 39576
  • Facility Phone: 228 467-4436
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TIFFANY VAN ACKER
  • NPI Number: 1730355694
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2039671
LAB Type Pharmacy
Facility Name WALGREENS #10321
Street 3348 HWY 90
City WAVELAND
State MS
ZIP 39576
Phone 228 467-4436
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 TIFFANY VAN ACKER

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