17D2061665 CLIA NUMBER - WALGREENS #12922

Laboratory Demographics

  • CLIA Code: 17D2061665
  • Facility Name: WALGREENS #12922
  • Facility Address: 550 SOUTH 129TH STREET
    BONNER SPRINGS, KS
    ZIP 66012
  • Facility Phone: 913 543-5001
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PARKER BOLEJACK
  • NPI Number: 1548590565
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 17D2061665
LAB Type Pharmacy
Facility Name WALGREENS #12922
Street 550 SOUTH 129TH STREET
City BONNER SPRINGS
State KS
ZIP 66012
Phone 913 543-5001
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 PARKER BOLEJACK

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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