39D2292445 CLIA NUMBER - WALGREENS #21323

Laboratory Demographics

  • CLIA Code: 39D2292445
  • Facility Name: WALGREENS #21323
  • Facility Address: 112 W CHELTEN AVE
    PHILADELPHIA, PA
    ZIP 19144
  • Facility Phone: 215 848-4651
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD DONG
  • NPI Number: 1235144122
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 39D2292445
LAB Type Pharmacy
Facility Name WALGREENS #21323
Street 112 W CHELTEN AVE
City PHILADELPHIA
State PA
ZIP 19144
Phone 215 848-4651
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/25/2023
Certificate Expiration Date 10/24/2025
Facility Type Pharmacy
Lab Director RICHARD DONG

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This page was last updated on: 6/4/2025