16D2228079 CLIA NUMBER - WALGREENS #07967

Laboratory Demographics

  • CLIA Code: 16D2228079
  • Facility Name: WALGREENS #07967
  • Facility Address: 15601 HICKMAN RD
    CLIVE, IA
    ZIP 50325
  • Facility Phone: 515 987-6807
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL VARGO
  • NPI Number: 1831105428
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 16D2228079
LAB Type Pharmacy
Facility Name WALGREENS #07967
Street 15601 HICKMAN RD
City CLIVE
State IA
ZIP 50325
Phone 515 987-6807
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/22/2025
Certificate Expiration Date 6/21/2027
Facility Type Pharmacy
Lab Director MICHAEL VARGO

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