17D2011254 CLIA NUMBER - WALGREENS #03055

Laboratory Demographics

  • CLIA Code: 17D2011254
  • Facility Name: WALGREENS #03055
  • Facility Address: 3421 W 6TH STREET
    LAWRENCE, KS
    ZIP 66049
  • Facility Phone: 785 841-9000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARK D. SIMONS
  • NPI Number: 1225043540
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2011254
LAB Type Pharmacy
Facility Name WALGREENS #03055
Street 3421 W 6TH STREET
City LAWRENCE
State KS
ZIP 66049
Phone 785 841-9000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director MARK D. SIMONS

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