41D2231005 CLIA NUMBER - WALGREENS #19470

Laboratory Demographics

  • CLIA Code: 41D2231005
  • Facility Name: WALGREENS #19470
  • Facility Address: 677 MAIN ROAD
    TIVERTON, RI
    ZIP 02878
  • Facility Phone: 401 624-8411
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN W. WILBUR
  • NPI Number: 1467975300
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2231005
LAB Type Pharmacy
Facility Name WALGREENS #19470
Street 677 MAIN ROAD
City TIVERTON
State RI
ZIP 02878
Phone 401 624-8411
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 KEVIN W. WILBUR

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