13D2034130 CLIA NUMBER - WALGREEN'S #12286

Laboratory Demographics

  • CLIA Code: 13D2034130
  • Facility Name: WALGREEN'S #12286
  • Facility Address: 1732 WASHINGTON ST N
    TWIN FALLS, ID
    ZIP 83301
  • Facility Phone: 208 733-1166
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT D. NEWSOM
  • NPI Number: 1528290640
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2034130
LAB Type Pharmacy
Facility Name WALGREEN'S #12286
Street 1732 WASHINGTON ST N
City TWIN FALLS
State ID
ZIP 83301
Phone 208 733-1166
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 ROBERT D. NEWSOM

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