13D2033082 CLIA NUMBER - WALGREEN'S #05565

Laboratory Demographics

  • CLIA Code: 13D2033082
  • Facility Name: WALGREEN'S #05565
  • Facility Address: 10555 W OVERLAND ROAD
    BOISE, ID
    ZIP 83709
  • Facility Phone: 208 321-2669
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SCOTT D. FLEMING
  • NPI Number: 1508871625
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2033082
LAB Type Pharmacy
Facility Name WALGREEN'S #05565
Street 10555 W OVERLAND ROAD
City BOISE
State ID
ZIP 83709
Phone 208 321-2669
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/18/2025
Certificate Expiration Date 10/17/2027
Facility Type Pharmacy
Lab Director SCOTT D. FLEMING

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