41D2205439 CLIA NUMBER - WALGREENS # 11147

Laboratory Demographics

  • CLIA Code: 41D2205439
  • Facility Name: WALGREENS # 11147
  • Facility Address: 1 POCASSET AVE
    PROVIDENCE, RI
    ZIP 02909
  • Facility Phone: 401 464-6501
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMEM AKPAN
  • NPI Number: 1770746075
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2205439
LAB Type Pharmacy
Facility Name WALGREENS # 11147
Street 1 POCASSET AVE
City PROVIDENCE
State RI
ZIP 02909
Phone 401 464-6501
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2024
Certificate Expiration Date 12/14/2026
Facility Type Pharmacy
Lab Director EMEM AKPAN

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