17D2020472 CLIA NUMBER - WALGREENS #12815

Laboratory Demographics

  • CLIA Code: 17D2020472
  • Facility Name: WALGREENS #12815
  • Facility Address: 1453 EAST 151ST STREET
    OLATHE, KS
    ZIP 66062
  • Facility Phone: 913 538-5019
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN J. HANEY
  • NPI Number: 1760614267
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2020472
LAB Type Pharmacy
Facility Name WALGREENS #12815
Street 1453 EAST 151ST STREET
City OLATHE
State KS
ZIP 66062
Phone 913 538-5019
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/22/2025
Certificate Expiration Date 7/21/2027
Facility Type Pharmacy
Lab Director JUSTIN J. HANEY

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