39D2294726 CLIA NUMBER - WALGREENS #12084

Laboratory Demographics

  • CLIA Code: 39D2294726
  • Facility Name: WALGREENS #12084
  • Facility Address: 1800 SOUTH ST
    PHILADELPHIA, PA
    ZIP 19146
  • Facility Phone: 267 273-7585
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRISTOPHER W. HANSEN
  • NPI Number: 1790016608
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 39D2294726
LAB Type Pharmacy
Facility Name WALGREENS #12084
Street 1800 SOUTH ST
City PHILADELPHIA
State PA
ZIP 19146
Phone 267 273-7585
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/29/2023
Certificate Expiration Date 11/28/2025
Facility Type Pharmacy
Lab Director CHRISTOPHER W. HANSEN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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