17D2011831 CLIA NUMBER - WALGREENS #05769

Laboratory Demographics

  • CLIA Code: 17D2011831
  • Facility Name: WALGREENS #05769
  • Facility Address: 3333 EAST CENTRAL AVENUE
    WICHITA, KS
    ZIP 67208
  • Facility Phone: 316 682-2999
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAYLOR D. WILLIAMS
  • NPI Number: 1952316275
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2011831
LAB Type Pharmacy
Facility Name WALGREENS #05769
Street 3333 EAST CENTRAL AVENUE
City WICHITA
State KS
ZIP 67208
Phone 316 682-2999
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director TAYLOR D. WILLIAMS

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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