51D2290004 CLIA NUMBER - WALGREENS 17111

Laboratory Demographics

  • CLIA Code: 51D2290004
  • Facility Name: WALGREENS 17111
  • Facility Address: 305 SIXTH AVENUE
    SAINT ALBANS, WV
    ZIP 25177
  • Facility Phone: 304 722-4617
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CARRIE G. HANNA
  • NPI Number: 1780108407
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 51D2290004
LAB Type Pharmacy
Facility Name WALGREENS 17111
Street 305 SIXTH AVENUE
City SAINT ALBANS
State WV
ZIP 25177
Phone 304 722-4617
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 CARRIE G. HANNA

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