44D2287623 CLIA NUMBER - WALGREENS #17551

Laboratory Demographics

  • CLIA Code: 44D2287623
  • Facility Name: WALGREENS #17551
  • Facility Address: 409 MULBERRY
    SELMER, TN
    ZIP 38375
  • Facility Phone: 731 645-4423
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STACIE M. BLACK
  • NPI Number: 1194240473
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 44D2287623
LAB Type Pharmacy
Facility Name WALGREENS #17551
Street 409 MULBERRY
City SELMER
State TN
ZIP 38375
Phone 731 645-4423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/16/2025
Certificate Expiration Date 8/15/2027
Facility Type Pharmacy
Lab Director STACIE M. BLACK

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