51D2043747 CLIA NUMBER - WALGREENS # 12454

Laboratory Demographics

  • CLIA Code: 51D2043747
  • Facility Name: WALGREENS # 12454
  • Facility Address: 655 WEST WASHINGTON STREET
    CHARLESTON, WV
    ZIP 25302
  • Facility Phone: 304 342-1798
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN L. CARTER
  • NPI Number: 1588899140
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2043747
LAB Type Pharmacy
Facility Name WALGREENS # 12454
Street 655 WEST WASHINGTON STREET
City CHARLESTON
State WV
ZIP 25302
Phone 304 342-1798
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director BRIAN L. CARTER

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