36D2055720 CLIA NUMBER - WALGREENS #06458

Laboratory Demographics

  • CLIA Code: 36D2055720
  • Facility Name: WALGREENS #06458
  • Facility Address: 805 N COURT ST
    MEDINA, OH
    ZIP 44256
  • Facility Phone: 330 764-4399
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGHAN BAXTER
  • NPI Number: 1164437190
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2055720
LAB Type Pharmacy
Facility Name WALGREENS #06458
Street 805 N COURT ST
City MEDINA
State OH
ZIP 44256
Phone 330 764-4399
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2025
Certificate Expiration Date 3/25/2027
Facility Type Pharmacy
Lab Director MEGHAN BAXTER

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