17D2011827 CLIA NUMBER - WALGREENS #05768

Laboratory Demographics

  • CLIA Code: 17D2011827
  • Facility Name: WALGREENS #05768
  • Facility Address: 5505 EAST HARRY STREET
    WICHITA, KS
    ZIP 67218
  • Facility Phone: 316 689-0866
  • Facility Type: Other - COVID 19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: MELISSA NGUYEN
  • NPI Number: 1043225360
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2011827
LAB Type Other - COVID 19 TEST SITE
Facility Name WALGREENS #05768
Street 5505 EAST HARRY STREET
City WICHITA
State KS
ZIP 67218
Phone 316 689-0866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Other - COVID 19 TEST SITE
Lab Director MELISSA NGUYEN

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