41D2291023 CLIA NUMBER - WALGREENS 19900

Laboratory Demographics

  • CLIA Code: 41D2291023
  • Facility Name: WALGREENS 19900
  • Facility Address: 135 PITMAN STREET
    PROVIDENCE, RI
    ZIP 02906
  • Facility Phone: 401 861-4846
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIANA S. FIELDS
  • NPI Number: 1447773213
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2291023
LAB Type Pharmacy
Facility Name WALGREENS 19900
Street 135 PITMAN STREET
City PROVIDENCE
State RI
ZIP 02906
Phone 401 861-4846
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/4/2025
Certificate Expiration Date 10/3/2027
Facility Type Pharmacy
Lab Director DIANA S. FIELDS

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