16D2030024 CLIA NUMBER - WALGREENS #05361

Laboratory Demographics

  • CLIA Code: 16D2030024
  • Facility Name: WALGREENS #05361
  • Facility Address: 2503 5TH AVENUE S
    FORT DODGE, IA
    ZIP 50501
  • Facility Phone: 515 576-7113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOMAS B. KELLY
  • NPI Number: 1366457673
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 16D2030024
LAB Type Pharmacy
Facility Name WALGREENS #05361
Street 2503 5TH AVENUE S
City FORT DODGE
State IA
ZIP 50501
Phone 515 576-7113
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 THOMAS B. KELLY

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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