36D2217404 CLIA NUMBER - WALGREENS #10915

Laboratory Demographics

  • CLIA Code: 36D2217404
  • Facility Name: WALGREENS #10915
  • Facility Address: 101 E SANDUSKY AVE
    BELLEFONTAINE, OH
    ZIP 43311
  • Facility Phone: 937 292-8104
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LEAH B. DOUGLASS
  • NPI Number: 1649498007
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2217404
LAB Type Pharmacy
Facility Name WALGREENS #10915
Street 101 E SANDUSKY AVE
City BELLEFONTAINE
State OH
ZIP 43311
Phone 937 292-8104
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 LEAH B. DOUGLASS

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