39D2226924 CLIA NUMBER - WALGREENS #07224

Laboratory Demographics

  • CLIA Code: 39D2226924
  • Facility Name: WALGREENS #07224
  • Facility Address: 119 E DEKALB PIKE
    KING OF PRUSSIA, PA
    ZIP 19406
  • Facility Phone: 610 962-9627
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN M. TICE
  • NPI Number: 1316952203
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2226924
LAB Type Pharmacy
Facility Name WALGREENS #07224
Street 119 E DEKALB PIKE
City KING OF PRUSSIA
State PA
ZIP 19406
Phone 610 962-9627
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/7/2025
Certificate Expiration Date 6/6/2027
Facility Type Pharmacy
Lab Director BRIAN M. TICE

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