17D2042871 CLIA NUMBER - WALGREENS #11167

Laboratory Demographics

  • CLIA Code: 17D2042871
  • Facility Name: WALGREENS #11167
  • Facility Address: 1502 INDUSTRIAL ROAD
    EMPORIA, KS
    ZIP 66801
  • Facility Phone: (620) 342-3301
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SASHA SOSA-MALLON
  • NPI Number: 1275748857
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2042871
LAB Type Pharmacy
Facility Name WALGREENS #11167
Street 1502 INDUSTRIAL ROAD
City EMPORIA
State KS
ZIP 66801
Phone 6203423301
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director SASHA SOSA-MALLON

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