51D2287432 CLIA NUMBER - WALGREENS 17949

Laboratory Demographics

  • CLIA Code: 51D2287432
  • Facility Name: WALGREENS 17949
  • Facility Address: 120 JEFFERSON AVE
    MOUNDSVILLE, WV
    ZIP 26041
  • Facility Phone: 304 845-4230
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER J. MYSLIWIEC
  • NPI Number: 1750807491
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2287432
LAB Type Pharmacy
Facility Name WALGREENS 17949
Street 120 JEFFERSON AVE
City MOUNDSVILLE
State WV
ZIP 26041
Phone 304 845-4230
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/15/2025
Certificate Expiration Date 8/14/2027
Facility Type Pharmacy
Lab Director PETER J. MYSLIWIEC

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