26D2013050 CLIA NUMBER - WALGREENS #05717

Laboratory Demographics

  • CLIA Code: 26D2013050
  • Facility Name: WALGREENS #05717
  • Facility Address: 890 WASHINGTON CORS
    WASHINGTON, MO
    ZIP 63090
  • Facility Phone: 636 239-7483
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRENEE N. KOCH
  • NPI Number: 1710992748
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2013050
LAB Type Pharmacy
Facility Name WALGREENS #05717
Street 890 WASHINGTON CORS
City WASHINGTON
State MO
ZIP 63090
Phone 636 239-7483
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director TRENEE N. KOCH

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