17D2219005 CLIA NUMBER - WALGREENS #12814

Laboratory Demographics

  • CLIA Code: 17D2219005
  • Facility Name: WALGREENS #12814
  • Facility Address: 2719 ANDERSON AVE
    MANHATTAN, KS
    ZIP 66502
  • Facility Phone: 785 587-8326
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAKE SCHULTZ
  • NPI Number: 1841429685
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2219005
LAB Type Pharmacy
Facility Name WALGREENS #12814
Street 2719 ANDERSON AVE
City MANHATTAN
State KS
ZIP 66502
Phone 785 587-8326
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Pharmacy
Lab Director LAKE SCHULTZ

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