36D2012980 CLIA NUMBER - WALGREENS #05196

Laboratory Demographics

  • CLIA Code: 36D2012980
  • Facility Name: WALGREENS #05196
  • Facility Address: 6355 DIXIE HIGHWAY
    FAIRFIELD, OH
    ZIP 45014
  • Facility Phone: 513 874-3528
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TERRI C. MAY
  • NPI Number: 1053326058
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2012980
LAB Type Pharmacy
Facility Name WALGREENS #05196
Street 6355 DIXIE HIGHWAY
City FAIRFIELD
State OH
ZIP 45014
Phone 513 874-3528
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/4/2025
Certificate Expiration Date 5/3/2027
Facility Type Pharmacy
Lab Director TERRI C. MAY

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