39D2220234 CLIA NUMBER - WALGREENS #11074

Laboratory Demographics

  • CLIA Code: 39D2220234
  • Facility Name: WALGREENS #11074
  • Facility Address: 2235 BALTIMORE PIKE
    OXFORD, PA
    ZIP 19363
  • Facility Phone: 484 365-1010
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CODY SMOLDT
  • NPI Number: 1447271770
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2220234
LAB Type Pharmacy
Facility Name WALGREENS #11074
Street 2235 BALTIMORE PIKE
City OXFORD
State PA
ZIP 19363
Phone 484 365-1010
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/11/2025
Certificate Expiration Date 4/10/2027
Facility Type Pharmacy
Lab Director CODY SMOLDT

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