47D2287395 CLIA NUMBER - WALGREENS 17185

Laboratory Demographics

  • CLIA Code: 47D2287395
  • Facility Name: WALGREENS 17185
  • Facility Address: 82 VT ROUTE 15W
    HARDWICK, VT
    ZIP 05843
  • Facility Phone: 802 472-6961
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOBAHIL AHMAD
  • NPI Number: 1558885194
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D2287395
LAB Type Pharmacy
Facility Name WALGREENS 17185
Street 82 VT ROUTE 15W
City HARDWICK
State VT
ZIP 05843
Phone 802 472-6961
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2023
Certificate Expiration Date 8/13/2025
Facility Type Pharmacy
Lab Director MOBAHIL AHMAD

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This page was last updated on: 6/4/2025