36D2086914 CLIA NUMBER - WALGREENS #15467

Laboratory Demographics

  • CLIA Code: 36D2086914
  • Facility Name: WALGREENS #15467
  • Facility Address: 110 LINCOLN WAY WEST
    MASSILLON, OH
    ZIP 44647
  • Facility Phone: 330 481-2042
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN MOORE
  • NPI Number: 1861892283
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2086914
LAB Type Pharmacy
Facility Name WALGREENS #15467
Street 110 LINCOLN WAY WEST
City MASSILLON
State OH
ZIP 44647
Phone 330 481-2042
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director BRIAN MOORE

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