51D2290003 CLIA NUMBER - WALGREENS 17408

Laboratory Demographics

  • CLIA Code: 51D2290003
  • Facility Name: WALGREENS 17408
  • Facility Address: 1015 BRIDGE ROAD
    CHARLESTON, WV
    ZIP 25314
  • Facility Phone: 304 344-2030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WHITNEY N. TIGNOR
  • NPI Number: 1326564170
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2290003
LAB Type Pharmacy
Facility Name WALGREENS 17408
Street 1015 BRIDGE ROAD
City CHARLESTON
State WV
ZIP 25314
Phone 304 344-2030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/19/2025
Certificate Expiration Date 9/18/2027
Facility Type Pharmacy
Lab Director WHITNEY N. TIGNOR

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