51D2287448 CLIA NUMBER - WALGREENS 19108

Laboratory Demographics

  • CLIA Code: 51D2287448
  • Facility Name: WALGREENS 19108
  • Facility Address: 4402 PENNSYLVANIA AVE
    BIG CHIMNEY, WV
    ZIP 25302
  • Facility Phone: 304 965-7301
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN L. TANTLINGER
  • NPI Number: 1942727698
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2287448
LAB Type Pharmacy
Facility Name WALGREENS 19108
Street 4402 PENNSYLVANIA AVE
City BIG CHIMNEY
State WV
ZIP 25302
Phone 304 965-7301
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 SUSAN L. TANTLINGER

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