17D2061663 CLIA NUMBER - WALGREENS #09376

Laboratory Demographics

  • CLIA Code: 17D2061663
  • Facility Name: WALGREENS #09376
  • Facility Address: 1445 S MAIN STREET
    OTTAWA, KS
    ZIP 66067
  • Facility Phone: 785 242-4745
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SIMRANJIT KAUR
  • NPI Number: 1629023882
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2061663
LAB Type Pharmacy
Facility Name WALGREENS #09376
Street 1445 S MAIN STREET
City OTTAWA
State KS
ZIP 66067
Phone 785 242-4745
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director SIMRANJIT KAUR

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