26D2012982 CLIA NUMBER - WALGREENS #05552

Laboratory Demographics

  • CLIA Code: 26D2012982
  • Facility Name: WALGREENS #05552
  • Facility Address: 920 N MAIN ST
    O FALLON, MO
    ZIP 63366
  • Facility Phone: 636 379-2636
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA R. WEIDLER
  • NPI Number: 1619984622
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2012982
LAB Type Pharmacy
Facility Name WALGREENS #05552
Street 920 N MAIN ST
City O FALLON
State MO
ZIP 63366
Phone 636 379-2636
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/17/2025
Certificate Expiration Date 9/16/2027
Facility Type Pharmacy
Lab Director JOSHUA R. WEIDLER

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