40D2255589 CLIA NUMBER - WALGREENS # 00165

Laboratory Demographics

  • CLIA Code: 40D2255589
  • Facility Name: WALGREENS # 00165
  • Facility Address: 2706 AVE AMERICA
    PONCE, PR
    ZIP 00728
  • Facility Phone: 787 812-5978
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CELINES RODRIGUEZ
  • NPI Number: 1508871666
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 40D2255589
LAB Type Pharmacy
Facility Name WALGREENS # 00165
Street 2706 AVE AMERICA
City PONCE
State PR
ZIP 00728
Phone 787 812-5978
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/16/2024
Certificate Expiration Date 3/15/2026
Facility Type Pharmacy
Lab Director CELINES RODRIGUEZ

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