51D2234085 CLIA NUMBER - WALGREENS #17700

Laboratory Demographics

  • CLIA Code: 51D2234085
  • Facility Name: WALGREENS #17700
  • Facility Address: 405 FAIRMONT ROAD
    WESTOVER, WV
    ZIP 26501
  • Facility Phone: 304 296-2547
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHANDLER B. HAINES
  • NPI Number: 1376067090
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2234085
LAB Type Pharmacy
Facility Name WALGREENS #17700
Street 405 FAIRMONT ROAD
City WESTOVER
State WV
ZIP 26501
Phone 304 296-2547
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/27/2025
Certificate Expiration Date 8/26/2027
Facility Type Pharmacy
Lab Director CHANDLER B. HAINES

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