36D2217477 CLIA NUMBER - WALGREENS #10784

Laboratory Demographics

  • CLIA Code: 36D2217477
  • Facility Name: WALGREENS #10784
  • Facility Address: 144 E MAIN ST
    RAVENNA, OH
    ZIP 44266
  • Facility Phone: 330 298-4297
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER L. CONTOFALSKY
  • NPI Number: 1477728541
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2217477
LAB Type Pharmacy
Facility Name WALGREENS #10784
Street 144 E MAIN ST
City RAVENNA
State OH
ZIP 44266
Phone 330 298-4297
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director JENNIFER L. CONTOFALSKY

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