16D2011277 CLIA NUMBER - WALGREENS #04041

Laboratory Demographics

  • CLIA Code: 16D2011277
  • Facility Name: WALGREENS #04041
  • Facility Address: 1525 E KIMBERLY ROAD
    DAVENPORT, IA
    ZIP 52807
  • Facility Phone: 563 386-6883
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARGIE M. DODDROE
  • NPI Number: 1356356661
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2011277
LAB Type Pharmacy
Facility Name WALGREENS #04041
Street 1525 E KIMBERLY ROAD
City DAVENPORT
State IA
ZIP 52807
Phone 563 386-6883
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/10/2023
Certificate Expiration Date 5/9/2025
Facility Type Pharmacy
Lab Director MARGIE M. DODDROE

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This page was last updated on: 3/20/2025