36D2217400 CLIA NUMBER - WALGREENS #07865

Laboratory Demographics

  • CLIA Code: 36D2217400
  • Facility Name: WALGREENS #07865
  • Facility Address: 1950 WALES RD NE
    MASSILLON, OH
    ZIP 44646
  • Facility Phone: 330 833-5730
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMANTHA CYPHERS
  • NPI Number: 1609881655
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2217400
LAB Type Pharmacy
Facility Name WALGREENS #07865
Street 1950 WALES RD NE
City MASSILLON
State OH
ZIP 44646
Phone 330 833-5730
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director SAMANTHA CYPHERS

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