36D2008169 CLIA NUMBER - WALGREENS #9873

Laboratory Demographics

  • CLIA Code: 36D2008169
  • Facility Name: WALGREENS #9873
  • Facility Address: 911 SOUTH MAIN STREET
    CENTERVILLE, OH
    ZIP 45458
  • Facility Phone: 937 291-3707
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHANIE ESTES
  • NPI Number: 1881609840
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2008169
LAB Type Pharmacy
Facility Name WALGREENS #9873
Street 911 SOUTH MAIN STREET
City CENTERVILLE
State OH
ZIP 45458
Phone 937 291-3707
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2025
Certificate Expiration Date 2/21/2027
Facility Type Pharmacy
Lab Director STEPHANIE ESTES

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This page was last updated on: 3/20/2025