25D2239297 CLIA NUMBER - WALGREENS #15804

Laboratory Demographics

  • CLIA Code: 25D2239297
  • Facility Name: WALGREENS #15804
  • Facility Address: 1357 VETERANS MEMORIAL BLVD
    EUPORA, MS
    ZIP 39744
  • Facility Phone: 662 258-2631
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN E. HUBBARD
  • NPI Number: 1013096783
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 25D2239297
LAB Type Pharmacy
Facility Name WALGREENS #15804
Street 1357 VETERANS MEMORIAL BLVD
City EUPORA
State MS
ZIP 39744
Phone 662 258-2631
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/11/2025
Certificate Expiration Date 10/10/2027
Facility Type Pharmacy
Lab Director BRIAN E. HUBBARD

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