26D2012526 CLIA NUMBER - WALGREEN #05247

Laboratory Demographics

  • CLIA Code: 26D2012526
  • Facility Name: WALGREEN #05247
  • Facility Address: 3915 S NOLAND RD
    INDEPENDENCE, MO
    ZIP 64055
  • Facility Phone: 816 254-8748
  • Facility Type: Other - COVID-19 TESTING SITE
  • Facility Type: Waiver
  • Lab Director: AMANDA TENHOLDER
  • NPI Number: 1174530182
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012526
LAB Type Other - COVID-19 TESTING SITE
Facility Name WALGREEN #05247
Street 3915 S NOLAND RD
City INDEPENDENCE
State MO
ZIP 64055
Phone 816 254-8748
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Other - COVID-19 TESTING SITE
Lab Director AMANDA TENHOLDER

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