36D2055719 CLIA NUMBER - WALGREENS #07541

Laboratory Demographics

  • CLIA Code: 36D2055719
  • Facility Name: WALGREENS #07541
  • Facility Address: 1425 N 21ST ST
    NEWARK, OH
    ZIP 43055
  • Facility Phone: 740 366-7119
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NKAFU M. ETCHI
  • NPI Number: 1245245281
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2055719
LAB Type Pharmacy
Facility Name WALGREENS #07541
Street 1425 N 21ST ST
City NEWARK
State OH
ZIP 43055
Phone 740 366-7119
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/1/2023
Certificate Expiration Date 10/31/2025
Facility Type Pharmacy
Lab Director NKAFU M. ETCHI

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