41D2291030 CLIA NUMBER - WALGREENS 19849

Laboratory Demographics

  • CLIA Code: 41D2291030
  • Facility Name: WALGREENS 19849
  • Facility Address: 655 WARREN AVE
    EAST PROVIDENCE, RI
    ZIP 02914
  • Facility Phone: 401 434-5700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN M. COSTA
  • NPI Number: 1396269882
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 41D2291030
LAB Type Pharmacy
Facility Name WALGREENS 19849
Street 655 WARREN AVE
City EAST PROVIDENCE
State RI
ZIP 02914
Phone 401 434-5700
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 JUSTIN M. COSTA

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