36D2011642 CLIA NUMBER - WALGREENS #06589

Laboratory Demographics

  • CLIA Code: 36D2011642
  • Facility Name: WALGREENS #06589
  • Facility Address: 5501 MAHONING AVENUE
    AUSTINTOWN, OH
    ZIP 44515
  • Facility Phone: 330 792-4785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTINE R. MILLER
  • NPI Number: 1245245273
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2011642
LAB Type Pharmacy
Facility Name WALGREENS #06589
Street 5501 MAHONING AVENUE
City AUSTINTOWN
State OH
ZIP 44515
Phone 330 792-4785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director CHRISTINE R. MILLER

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