13D2034133 CLIA NUMBER - WALGREEN'S #09157

Laboratory Demographics

  • CLIA Code: 13D2034133
  • Facility Name: WALGREEN'S #09157
  • Facility Address: 4257 YELLOWSTONE AVE
    CHUBBUCK, ID
    ZIP 83202
  • Facility Phone: 208 237-3940
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MEGAN D. LENIHAN
  • NPI Number: 1316952435
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2034133
LAB Type Pharmacy
Facility Name WALGREEN'S #09157
Street 4257 YELLOWSTONE AVE
City CHUBBUCK
State ID
ZIP 83202
Phone 208 237-3940
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/14/2025
Certificate Expiration Date 7/13/2027
Facility Type Pharmacy
Lab Director MEGAN D. LENIHAN

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