13D2033575 CLIA NUMBER - WALGREEN'S #10672

Laboratory Demographics

  • CLIA Code: 13D2033575
  • Facility Name: WALGREEN'S #10672
  • Facility Address: 2219 12TH AVENUE RD
    NAMPA, ID
    ZIP 83686
  • Facility Phone: 208 318-0536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CASSIE HUCKABAY
  • NPI Number: 1386839678
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2033575
LAB Type Pharmacy
Facility Name WALGREEN'S #10672
Street 2219 12TH AVENUE RD
City NAMPA
State ID
ZIP 83686
Phone 208 318-0536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director CASSIE HUCKABAY

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