41D2225365 CLIA NUMBER - WALGREENS #11128

Laboratory Demographics

  • CLIA Code: 41D2225365
  • Facility Name: WALGREENS #11128
  • Facility Address: 875 TIOGUE AVE
    COVENTRY, RI
    ZIP 02816
  • Facility Phone: 401 822-7602
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SAMUEL LACHAPELLE
  • NPI Number: 1932515939
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2225365
LAB Type Pharmacy
Facility Name WALGREENS #11128
Street 875 TIOGUE AVE
City COVENTRY
State RI
ZIP 02816
Phone 401 822-7602
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/20/2025
Certificate Expiration Date 5/19/2027
Facility Type Pharmacy
Lab Director SAMUEL LACHAPELLE

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