36D2041032 CLIA NUMBER - WALGREENS #12159

Laboratory Demographics

  • CLIA Code: 36D2041032
  • Facility Name: WALGREENS #12159
  • Facility Address: 1900 WEST STATE STREET
    FREMONT, OH
    ZIP 43420
  • Facility Phone: 419 355-9760
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JACKIE L. MESSINA
  • NPI Number: 1710123278
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2041032
LAB Type Pharmacy
Facility Name WALGREENS #12159
Street 1900 WEST STATE STREET
City FREMONT
State OH
ZIP 43420
Phone 419 355-9760
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director JACKIE L. MESSINA

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