40D2055756 CLIA NUMBER - WALGREENS 65 INF Y FRAGOSO (ST 174)

Laboratory Demographics

  • CLIA Code: 40D2055756
  • Facility Name: WALGREENS 65 INF Y FRAGOSO (ST 174)
  • Facility Address: INTERSECCION 65 INFANTERIA Y JESUS FRAGOSO
    CAROLINA, PR
    ZIP 00983
  • Facility Phone: 787 769-4122
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MRS. CELINES RODRIGUEZ
  • NPI Number: 1831313675
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 40D2055756
LAB Type Pharmacy
Facility Name WALGREENS 65 INF Y FRAGOSO (ST 174)
Street INTERSECCION 65 INFANTERIA Y JESUS FRAGOSO
City CAROLINA
State PR
ZIP 00983
Phone 787 769-4122
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/18/2025
Certificate Expiration Date 3/17/2027
Facility Type Pharmacy
Lab Director MRS. CELINES RODRIGUEZ

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