17D1099737 CLIA NUMBER - WALGREENS #09425

Laboratory Demographics

  • CLIA Code: 17D1099737
  • Facility Name: WALGREENS #09425
  • Facility Address: 5455 ROBERTS STREET
    SHAWNEE, KS
    ZIP 66226
  • Facility Phone: 913 667-1728
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KYLE W. MEYER
  • NPI Number: 1437307329
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D1099737
LAB Type Pharmacy
Facility Name WALGREENS #09425
Street 5455 ROBERTS STREET
City SHAWNEE
State KS
ZIP 66226
Phone 913 667-1728
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2025
Certificate Expiration Date 4/21/2027
Facility Type Pharmacy
Lab Director KYLE W. MEYER

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This page was last updated on: 6/4/2025