06D2229710 CLIA NUMBER - WALGREENS #17003

Laboratory Demographics

  • CLIA Code: 06D2229710
  • Facility Name: WALGREENS #17003
  • Facility Address: 1013 11TH STREET
    GREELEY, CO
    ZIP 80631
  • Facility Phone: 970 304-1218
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIO MENA MENDEZ
  • NPI Number: 1205352960
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 06D2229710
LAB Type Pharmacy
Facility Name WALGREENS #17003
Street 1013 11TH STREET
City GREELEY
State CO
ZIP 80631
Phone 970 304-1218
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/15/2025
Certificate Expiration Date 7/14/2027
Facility Type Pharmacy
Lab Director MARIO MENA MENDEZ

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