16D2030019 CLIA NUMBER - WALGREENS #01301

Laboratory Demographics

  • CLIA Code: 16D2030019
  • Facility Name: WALGREENS #01301
  • Facility Address: 327 W 4TH STREET
    OTTUMWA, IA
    ZIP 52501
  • Facility Phone: 641 226-5077
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GREGORY V. CLODFELTER
  • NPI Number: 1144235466
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2030019
LAB Type Pharmacy
Facility Name WALGREENS #01301
Street 327 W 4TH STREET
City OTTUMWA
State IA
ZIP 52501
Phone 641 226-5077
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director GREGORY V. CLODFELTER

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