17D2011261 CLIA NUMBER - WALGREENS #04186

Laboratory Demographics

  • CLIA Code: 17D2011261
  • Facility Name: WALGREENS #04186
  • Facility Address: 15100 W 87TH STREET PKWY
    LENEXA, KS
    ZIP 66219
  • Facility Phone: 913 438-5172
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DENNIS L. BEAN
  • NPI Number: 1053326272
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2011261
LAB Type Pharmacy
Facility Name WALGREENS #04186
Street 15100 W 87TH STREET PKWY
City LENEXA
State KS
ZIP 66219
Phone 913 438-5172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2025
Certificate Expiration Date 7/7/2027
Facility Type Pharmacy
Lab Director DENNIS L. BEAN

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