41D2230983 CLIA NUMBER - WALGREENS #17519

Laboratory Demographics

  • CLIA Code: 41D2230983
  • Facility Name: WALGREENS #17519
  • Facility Address: 220 NEWPORT AVE
    EAST PROVIDENCE, RI
    ZIP 02916
  • Facility Phone: 401 434-1333
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW J. FEDERICO
  • NPI Number: 1295258077
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2230983
LAB Type Pharmacy
Facility Name WALGREENS #17519
Street 220 NEWPORT AVE
City EAST PROVIDENCE
State RI
ZIP 02916
Phone 401 434-1333
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/29/2025
Certificate Expiration Date 7/28/2027
Facility Type Pharmacy
Lab Director MATTHEW J. FEDERICO

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