16D2219057 CLIA NUMBER - WALGREENS #05306

Laboratory Demographics

  • CLIA Code: 16D2219057
  • Facility Name: WALGREENS #05306
  • Facility Address: 301 W BENNETT AVE
    COUNCIL BLUFFS, IA
    ZIP 51503
  • Facility Phone: 712 325-0619
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAELA R. TOMSU
  • NPI Number: 1083629398
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2219057
LAB Type Pharmacy
Facility Name WALGREENS #05306
Street 301 W BENNETT AVE
City COUNCIL BLUFFS
State IA
ZIP 51503
Phone 712 325-0619
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Pharmacy
Lab Director MICHAELA R. TOMSU

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