26D2012628 CLIA NUMBER - WALGREENS #03305

Laboratory Demographics

  • CLIA Code: 26D2012628
  • Facility Name: WALGREENS #03305
  • Facility Address: 12661 OLIVE BLVD
    CREVE COEUR, MO
    ZIP 63141
  • Facility Phone: 314 878-4413
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RUSSELL G. MILLS
  • NPI Number: 1386659522
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012628
LAB Type Pharmacy
Facility Name WALGREENS #03305
Street 12661 OLIVE BLVD
City CREVE COEUR
State MO
ZIP 63141
Phone 314 878-4413
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2025
Certificate Expiration Date 4/25/2027
Facility Type Pharmacy
Lab Director RUSSELL G. MILLS

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