44D2032535 CLIA NUMBER - WALGREENS #10164

Laboratory Demographics

  • CLIA Code: 44D2032535
  • Facility Name: WALGREENS #10164
  • Facility Address: 4440 HIGHWAY 411
    MADISONVILLE, TN
    ZIP 37354
  • Facility Phone: 423 442-4778
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PAUL D. DACUS
  • NPI Number: 1881649630
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2032535
LAB Type Pharmacy
Facility Name WALGREENS #10164
Street 4440 HIGHWAY 411
City MADISONVILLE
State TN
ZIP 37354
Phone 423 442-4778
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/27/2025
Certificate Expiration Date 3/26/2027
Facility Type Pharmacy
Lab Director PAUL D. DACUS

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