26D2012563 CLIA NUMBER - WALGREENS #4702

Laboratory Demographics

  • CLIA Code: 26D2012563
  • Facility Name: WALGREENS #4702
  • Facility Address: 1000 CROSSROADS PL
    HIGH RIDGE, MO
    ZIP 63049
  • Facility Phone: 636 376-4785
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIELLE E. CROSTIC
  • NPI Number: 1992710925
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012563
LAB Type Pharmacy
Facility Name WALGREENS #4702
Street 1000 CROSSROADS PL
City HIGH RIDGE
State MO
ZIP 63049
Phone 636 376-4785
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/19/2025
Certificate Expiration Date 10/18/2027
Facility Type Pharmacy
Lab Director DANIELLE E. CROSTIC

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