13D2033573 CLIA NUMBER - WALGREENS #13105

Laboratory Demographics

  • CLIA Code: 13D2033573
  • Facility Name: WALGREENS #13105
  • Facility Address: 184 W HIGHWAY 52
    EMMETT, ID
    ZIP 83617
  • Facility Phone: 208 365-4327
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NGOC T. LUONG PHARMD
  • NPI Number: 1225345374
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2033573
LAB Type Pharmacy
Facility Name WALGREENS #13105
Street 184 W HIGHWAY 52
City EMMETT
State ID
ZIP 83617
Phone 208 365-4327
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2025
Certificate Expiration Date 1/18/2027
Facility Type Pharmacy
Lab Director NGOC T. LUONG PHARMD

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This page was last updated on: 3/20/2025