40D2055769 CLIA NUMBER - WALGREENS MANATI (ST 412)

Laboratory Demographics

  • CLIA Code: 40D2055769
  • Facility Name: WALGREENS MANATI (ST 412)
  • Facility Address: 10 CARR 149 # 100 INTERSECCION 149 Y PR 2
    MANATI, PR
    ZIP 00674
  • Facility Phone: 787 884-0545
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DENNIS RUIZ
  • NPI Number: 1962675108
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 40D2055769
LAB Type Pharmacy
Facility Name WALGREENS MANATI (ST 412)
Street 10 CARR 149 # 100 INTERSECCION 149 Y PR 2
City MANATI
State PR
ZIP 00674
Phone 787 884-0545
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 DENNIS RUIZ

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