36D2037901 CLIA NUMBER - WALGREENS #05431

Laboratory Demographics

  • CLIA Code: 36D2037901
  • Facility Name: WALGREENS #05431
  • Facility Address: 1337 PEARL ROAD
    BRUNSWICK, OH
    ZIP 44212
  • Facility Phone: 330 220-3225
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEBRA A. LIESKE
  • NPI Number: 1871508895
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2037901
LAB Type Pharmacy
Facility Name WALGREENS #05431
Street 1337 PEARL ROAD
City BRUNSWICK
State OH
ZIP 44212
Phone 330 220-3225
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2023
Certificate Expiration Date 7/28/2025
Facility Type Pharmacy
Lab Director DEBRA A. LIESKE

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This page was last updated on: 6/4/2025