17D2019673 CLIA NUMBER - WALGREENS #13032

Laboratory Demographics

  • CLIA Code: 17D2019673
  • Facility Name: WALGREENS #13032
  • Facility Address: 4016 WEST 95TH STREET
    PRAIRIE VILLAGE, KS
    ZIP 66207
  • Facility Phone: 913 307-3057
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HA H. THUY
  • NPI Number: 1659699213
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2019673
LAB Type Pharmacy
Facility Name WALGREENS #13032
Street 4016 WEST 95TH STREET
City PRAIRIE VILLAGE
State KS
ZIP 66207
Phone 913 307-3057
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/2/2025
Certificate Expiration Date 3/1/2027
Facility Type Pharmacy
Lab Director HA H. THUY

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