26D2013045 CLIA NUMBER - WALGREENS #05120

Laboratory Demographics

  • CLIA Code: 26D2013045
  • Facility Name: WALGREENS #05120
  • Facility Address: 12006 MANCHESTER RD
    DES PERES, MO
    ZIP 63131
  • Facility Phone: 314 965-0030
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EMMA L. SHANNON
  • NPI Number: 1093720237
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2013045
LAB Type Pharmacy
Facility Name WALGREENS #05120
Street 12006 MANCHESTER RD
City DES PERES
State MO
ZIP 63131
Phone 314 965-0030
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director EMMA L. SHANNON

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