17D2061357 CLIA NUMBER - WALGREENS #6112

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Laboratory Demographics

CLIA Number: 17D2061357

Facility Name: WALGREENS #6112

Facility Address:
15066 WEST 151ST STREET
OLATHE, KS
ZIP 66062
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Facility Phone Number: 913 393-2886

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1326054966

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	17D2061357
LAB Type	Pharmacy
Facility Name	WALGREENS #6112
Street	15066 WEST 151ST STREET
City	OLATHE
State	KS
ZIP	66062
Phone	913 393-2886
CertificateType	4
CertificateEffectiveDate	7/22/2023
CertificateExpirationDate	7/21/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024