13D2033514 CLIA NUMBER - WALGREEN'S #10197

Laboratory Demographics

  • CLIA Code: 13D2033514
  • Facility Name: WALGREEN'S #10197
  • Facility Address: 3150 W CHERRY LANE
    MERIDIAN, ID
    ZIP 83642
  • Facility Phone: 208 319-2312
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANE D. GONZALES
  • NPI Number: 1962575241
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 13D2033514
LAB Type Pharmacy
Facility Name WALGREEN'S #10197
Street 3150 W CHERRY LANE
City MERIDIAN
State ID
ZIP 83642
Phone 208 319-2312
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/5/2025
Certificate Expiration Date 2/4/2027
Facility Type Pharmacy
Lab Director DANE D. GONZALES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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