16D2011270 CLIA NUMBER - WALGREENS #05060

Laboratory Demographics

  • CLIA Code: 16D2011270
  • Facility Name: WALGREENS #05060
  • Facility Address: 12753 UNIVERSITY AVENUE
    CLIVE, IA
    ZIP 50325
  • Facility Phone: 515 226-1786
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALMA J. MICHELSON
  • NPI Number: 1427063742
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2011270
LAB Type Pharmacy
Facility Name WALGREENS #05060
Street 12753 UNIVERSITY AVENUE
City CLIVE
State IA
ZIP 50325
Phone 515 226-1786
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 ALMA J. MICHELSON

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