26D2012561 CLIA NUMBER - WALGREENS #03906

Laboratory Demographics

  • CLIA Code: 26D2012561
  • Facility Name: WALGREENS #03906
  • Facility Address: 7339 GRAVOIS AVE
    SAINT LOUIS, MO
    ZIP 63116
  • Facility Phone: 314 752-0722
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELVIRA TATAR
  • NPI Number: 1932116944
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012561
LAB Type Pharmacy
Facility Name WALGREENS #03906
Street 7339 GRAVOIS AVE
City SAINT LOUIS
State MO
ZIP 63116
Phone 314 752-0722
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2025
Certificate Expiration Date 5/25/2027
Facility Type Pharmacy
Lab Director ELVIRA TATAR

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