16D2221003 CLIA NUMBER - WALGREENS #05512

Laboratory Demographics

  • CLIA Code: 16D2221003
  • Facility Name: WALGREENS #05512
  • Facility Address: 3425 MIDDLE ROAD
    BETTENDORF, IA
    ZIP 52722
  • Facility Phone: 563 332-6049
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LISA E. CRAWFORD
  • NPI Number: 1023024429
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2221003
LAB Type Pharmacy
Facility Name WALGREENS #05512
Street 3425 MIDDLE ROAD
City BETTENDORF
State IA
ZIP 52722
Phone 563 332-6049
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director LISA E. CRAWFORD

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