17D2051919 CLIA NUMBER - WALGREENS #7818

Laboratory Demographics

  • CLIA Code: 17D2051919
  • Facility Name: WALGREENS #7818
  • Facility Address: 3920 10TH STREET
    GREAT BEND, KS
    ZIP 67530
  • Facility Phone: 620 792-4467
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONA Z. DIEC
  • NPI Number: 1124033345
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2051919
LAB Type Pharmacy
Facility Name WALGREENS #7818
Street 3920 10TH STREET
City GREAT BEND
State KS
ZIP 67530
Phone 620 792-4467
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director DONA Z. DIEC

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