26D2012172 CLIA NUMBER - WALGREENS #09796

Laboratory Demographics

  • CLIA Code: 26D2012172
  • Facility Name: WALGREENS #09796
  • Facility Address: 588 S JEFFERSON AVE
    LEBANON, MO
    ZIP 65536
  • Facility Phone: 417 532-9403
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM PHIPPS
  • NPI Number: 1801801840
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012172
LAB Type Pharmacy
Facility Name WALGREENS #09796
Street 588 S JEFFERSON AVE
City LEBANON
State MO
ZIP 65536
Phone 417 532-9403
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director WILLIAM PHIPPS

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