14D2058663 CLIA NUMBER - WALGREENS #05720

Laboratory Demographics

  • CLIA Code: 14D2058663
  • Facility Name: WALGREENS #05720
  • Facility Address: 3601 16TH ST
    MOLINE, IL
    ZIP 61265
  • Facility Phone: 309 797-5865
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PATRICK DODDROE
  • NPI Number: 1700891926
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 14D2058663
LAB Type Pharmacy
Facility Name WALGREENS #05720
Street 3601 16TH ST
City MOLINE
State IL
ZIP 61265
Phone 309 797-5865
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director PATRICK DODDROE

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