51D2043750 CLIA NUMBER - WALGREENS # 11980

Laboratory Demographics

  • CLIA Code: 51D2043750
  • Facility Name: WALGREENS # 11980
  • Facility Address: 111 4TH AVENUE
    HUNTINGTON, WV
    ZIP 25701
  • Facility Phone: 304 523-3502
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMY ISON
  • NPI Number: 1003057811
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2043750
LAB Type Pharmacy
Facility Name WALGREENS # 11980
Street 111 4TH AVENUE
City HUNTINGTON
State WV
ZIP 25701
Phone 304 523-3502
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/31/2023
Certificate Expiration Date 8/30/2025
Facility Type Pharmacy
Lab Director AMY ISON

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