44D2032553 CLIA NUMBER - WALGREENS #10815

Laboratory Demographics

  • CLIA Code: 44D2032553
  • Facility Name: WALGREENS #10815
  • Facility Address: 483 W BOCKMAN WAY
    SPARTA, TN
    ZIP 38583
  • Facility Phone: 931 836-3230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANTLEY UNDERWOOD
  • NPI Number: 1851817258
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2032553
LAB Type Pharmacy
Facility Name WALGREENS #10815
Street 483 W BOCKMAN WAY
City SPARTA
State TN
ZIP 38583
Phone 931 836-3230
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 BRANTLEY UNDERWOOD

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