51D2234274 CLIA NUMBER - WALGREENS #19258

Laboratory Demographics

  • CLIA Code: 51D2234274
  • Facility Name: WALGREENS #19258
  • Facility Address: 627 FAIRMONT AVENUE
    FAIRMONT, WV
    ZIP 26554
  • Facility Phone: 304 366-4526
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSH G. DZIELSKI
  • NPI Number: 1417473000
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2234274
LAB Type Pharmacy
Facility Name WALGREENS #19258
Street 627 FAIRMONT AVENUE
City FAIRMONT
State WV
ZIP 26554
Phone 304 366-4526
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/30/2025
Certificate Expiration Date 8/29/2027
Facility Type Pharmacy
Lab Director JOSH G. DZIELSKI

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