51D2234090 CLIA NUMBER - WALGREENS #12276

Laboratory Demographics

  • CLIA Code: 51D2234090
  • Facility Name: WALGREENS #12276
  • Facility Address: 1240 W MAIN ST
    BRIDGEPORT, WV
    ZIP 26330
  • Facility Phone: 304 842-0647
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STEPHEN M. CHAMBERS
  • NPI Number: 1609179860
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2234090
LAB Type Pharmacy
Facility Name WALGREENS #12276
Street 1240 W MAIN ST
City BRIDGEPORT
State WV
ZIP 26330
Phone 304 842-0647
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 STEPHEN M. CHAMBERS

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