47D2292800 CLIA NUMBER - WALGREENS 17596

Laboratory Demographics

  • CLIA Code: 47D2292800
  • Facility Name: WALGREENS 17596
  • Facility Address: 29 MAIN ST
    MONTPELIER, VT
    ZIP 05602
  • Facility Phone: 802 223-4787
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NATHANIEL B. FOX
  • NPI Number: 1073036653
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D2292800
LAB Type Pharmacy
Facility Name WALGREENS 17596
Street 29 MAIN ST
City MONTPELIER
State VT
ZIP 05602
Phone 802 223-4787
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/31/2023
Certificate Expiration Date 10/30/2025
Facility Type Pharmacy
Lab Director NATHANIEL B. FOX

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