16D2191406 CLIA NUMBER - WALGREENS #12393

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Laboratory Demographics

CLIA Number: 16D2191406

Facility Name: WALGREENS #12393

Facility Address:
5750 C AVE NE
CEDAR RAPIDS, IA
ZIP 52402
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Facility Phone Number: 515 745-7420

Facility Type: Other - COVID-19 TEST SITE

Certificate Type: Waiver

NPI Number: 1184948408

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	16D2191406
LAB Type	Other - COVID-19 TEST SITE
Facility Name	WALGREENS #12393
Street	5750 C AVE NE
City	CEDAR RAPIDS
State	IA
ZIP	52402
Phone	515 745-7420
CertificateType	4
CertificateEffectiveDate	8/26/2022
CertificateExpirationDate	8/25/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024