06D2012955 CLIA NUMBER - WALGREENS #09212

Laboratory Demographics

  • CLIA Code: 06D2012955
  • Facility Name: WALGREENS #09212
  • Facility Address: 3700 W 10TH ST
    GREELEY, CO
    ZIP 80634
  • Facility Phone: 970 475-0192
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MISTY R. SHANDERA
  • NPI Number: 1255447553
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2012955
LAB Type Pharmacy
Facility Name WALGREENS #09212
Street 3700 W 10TH ST
City GREELEY
State CO
ZIP 80634
Phone 970 475-0192
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director MISTY R. SHANDERA

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