17D2011838 CLIA NUMBER - WALGREENS #06006

Laboratory Demographics

  • CLIA Code: 17D2011838
  • Facility Name: WALGREENS #06006
  • Facility Address: 9525 EAST 21ST STREET NORTH
    WICHITA, KS
    ZIP 67206
  • Facility Phone: 316 631-1401
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: NATHAN S. HALL
  • NPI Number: 1316952534
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2011838
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #06006
Street 9525 EAST 21ST STREET NORTH
City WICHITA
State KS
ZIP 67206
Phone 316 631-1401
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director NATHAN S. HALL

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