47D2292802 CLIA NUMBER - WALGREENS 17518

Laboratory Demographics

  • CLIA Code: 47D2292802
  • Facility Name: WALGREENS 17518
  • Facility Address: 355 NORTH MAIN ST
    BARRE, VT
    ZIP 05641
  • Facility Phone: 802 475-4311
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOUNICA B. NAYAKUDUGARI
  • NPI Number: 1548783152
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 47D2292802
LAB Type Pharmacy
Facility Name WALGREENS 17518
Street 355 NORTH MAIN ST
City BARRE
State VT
ZIP 05641
Phone 802 475-4311
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 MOUNICA B. NAYAKUDUGARI

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