51D2234582 CLIA NUMBER - WALGREENS #17274

Laboratory Demographics

  • CLIA Code: 51D2234582
  • Facility Name: WALGREENS #17274
  • Facility Address: 201 ROOSEVELT BLVD
    ELEANOR, WV
    ZIP 25070
  • Facility Phone: 304 586-9064
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID L. HENDREN
  • NPI Number: 1992220628
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2234582
LAB Type Pharmacy
Facility Name WALGREENS #17274
Street 201 ROOSEVELT BLVD
City ELEANOR
State WV
ZIP 25070
Phone 304 586-9064
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/1/2025
Certificate Expiration Date 8/31/2027
Facility Type Pharmacy
Lab Director DAVID L. HENDREN

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