39D2222877 CLIA NUMBER - WALGREENS #07196

Laboratory Demographics

  • CLIA Code: 39D2222877
  • Facility Name: WALGREENS #07196
  • Facility Address: 710 N WALES RD
    NORTH WALES, PA
    ZIP 19454
  • Facility Phone: 215 412-8709
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMILA ELLISON
  • NPI Number: 1952316846
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2222877
LAB Type Pharmacy
Facility Name WALGREENS #07196
Street 710 N WALES RD
City NORTH WALES
State PA
ZIP 19454
Phone 215 412-8709
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director JAMILA ELLISON

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