13D2033415 CLIA NUMBER - WALGREENS #06200

Laboratory Demographics

  • CLIA Code: 13D2033415
  • Facility Name: WALGREENS #06200
  • Facility Address: 1570 E FAIRVIEW AVE
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 888-0034
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN CARNEY SR
  • NPI Number: 1235144353
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2033415
LAB Type Pharmacy
Facility Name WALGREENS #06200
Street 1570 E FAIRVIEW AVE
City MERIDIAN
State ID
ZIP 83642
Phone 208 888-0034
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/5/2025
Certificate Expiration Date 4/4/2027
Facility Type Pharmacy
Lab Director JUSTIN CARNEY SR

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