44D2191469 CLIA NUMBER - WALGREENS #05474

Laboratory Demographics

  • CLIA Code: 44D2191469
  • Facility Name: WALGREENS #05474
  • Facility Address: 500 S WILLOW AVE
    COOKEVILLE, TN
    ZIP 38501
  • Facility Phone: 931 525-6240
  • Facility Type: Other - COVID-19 TEST
  • Facility Type: Waiver
  • Lab Director: DR. GARRY POTTER
  • NPI Number: 1932114956
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2191469
LAB Type Other - COVID-19 TEST
Facility Name WALGREENS #05474
Street 500 S WILLOW AVE
City COOKEVILLE
State TN
ZIP 38501
Phone 931 525-6240
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2024
Certificate Expiration Date 8/26/2026
Facility Type Other - COVID-19 TEST
Lab Director DR. GARRY POTTER

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