16D2011272 CLIA NUMBER - WALGREENS #05721

Laboratory Demographics

  • CLIA Code: 16D2011272
  • Facility Name: WALGREENS #05721
  • Facility Address: 3140 SE 14TH STREET
    DES MOINES, IA
    ZIP 50320
  • Facility Phone: 515 282-5295
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA P. ROEHRICK
  • NPI Number: 1629083936
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2011272
LAB Type Pharmacy
Facility Name WALGREENS #05721
Street 3140 SE 14TH STREET
City DES MOINES
State IA
ZIP 50320
Phone 515 282-5295
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director JOSHUA P. ROEHRICK

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