16D2012471 CLIA NUMBER - WALGREENS #07452

Laboratory Demographics

  • CLIA Code: 16D2012471
  • Facility Name: WALGREENS #07452
  • Facility Address: 4415 DOUGLAS AVENUE
    DES MOINES, IA
    ZIP 50310
  • Facility Phone: 515 279-4739
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMILY R. HOUSEHOLTER
  • NPI Number: 1619982923
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2012471
LAB Type Pharmacy
Facility Name WALGREENS #07452
Street 4415 DOUGLAS AVENUE
City DES MOINES
State IA
ZIP 50310
Phone 515 279-4739
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/17/2025
Certificate Expiration Date 5/16/2027
Facility Type Pharmacy
Lab Director EMILY R. HOUSEHOLTER

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