17D2039690 CLIA NUMBER - WALGREENS #07148

Laboratory Demographics

  • CLIA Code: 17D2039690
  • Facility Name: WALGREENS #07148
  • Facility Address: 510 E 30TH AVE
    HUTCHINSON, KS
    ZIP 67502
  • Facility Phone: (620) 663-2241
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRADLEY BLACKBURN
  • NPI Number: 1497760615
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2039690
LAB Type Pharmacy
Facility Name WALGREENS #07148
Street 510 E 30TH AVE
City HUTCHINSON
State KS
ZIP 67502
Phone 6206632241
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director BRADLEY BLACKBURN

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This page was last updated on: 5/18/2026