17D1107367 CLIA NUMBER - WALGREENS #06113

Laboratory Demographics

  • CLIA Code: 17D1107367
  • Facility Name: WALGREENS #06113
  • Facility Address: 1625 S WEBB ROAD
    WICHITA, KS
    ZIP 67207
  • Facility Phone: 316 652-9147
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GIANG D. HOANG
  • NPI Number: 1407861628
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D1107367
LAB Type Pharmacy
Facility Name WALGREENS #06113
Street 1625 S WEBB ROAD
City WICHITA
State KS
ZIP 67207
Phone 316 652-9147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director GIANG D. HOANG

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