26D2013043 CLIA NUMBER - WALGREENS #04701

Laboratory Demographics

  • CLIA Code: 26D2013043
  • Facility Name: WALGREENS #04701
  • Facility Address: 16105 MANCHESTER RD
    ELLISVILLE, MO
    ZIP 63011
  • Facility Phone: 636 391-3202
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ZEESHAN TOOR
  • NPI Number: 1578570586
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2013043
LAB Type Pharmacy
Facility Name WALGREENS #04701
Street 16105 MANCHESTER RD
City ELLISVILLE
State MO
ZIP 63011
Phone 636 391-3202
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director ZEESHAN TOOR

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