36D2287996 CLIA NUMBER - WALGREENS 07046

Laboratory Demographics

  • CLIA Code: 36D2287996
  • Facility Name: WALGREENS 07046
  • Facility Address: 4610 PLEASANT AVE
    FAIRFIELD, OH
    ZIP 45014
  • Facility Phone: 513 856-9400
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW J. GIBSON
  • NPI Number: 1992712996
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2287996
LAB Type Pharmacy
Facility Name WALGREENS 07046
Street 4610 PLEASANT AVE
City FAIRFIELD
State OH
ZIP 45014
Phone 513 856-9400
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/21/2025
Certificate Expiration Date 8/20/2027
Facility Type Pharmacy
Lab Director MATTHEW J. GIBSON

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