13D2034635 CLIA NUMBER - WALGREENS #04942

Laboratory Demographics

  • CLIA Code: 13D2034635
  • Facility Name: WALGREENS #04942
  • Facility Address: 8100 W FAIRVIEW AVE
    BOISE, ID
    ZIP 83704
  • Facility Phone: 208 375-2825
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFREY BUFFINGTON
  • NPI Number: 1881609907
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 13D2034635
LAB Type Pharmacy
Facility Name WALGREENS #04942
Street 8100 W FAIRVIEW AVE
City BOISE
State ID
ZIP 83704
Phone 208 375-2825
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/23/2025
Certificate Expiration Date 2/22/2027
Facility Type Pharmacy
Lab Director JEFFREY BUFFINGTON

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