26D2013055 CLIA NUMBER - WALGREENS #09481

Laboratory Demographics

  • CLIA Code: 26D2013055
  • Facility Name: WALGREENS #09481
  • Facility Address: 12509 DORSETT RD
    MARYLAND HEIGHTS, MO
    ZIP 63043
  • Facility Phone: 314 434-4224
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAMMY P. HYLAN
  • NPI Number: 1194730333
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2013055
LAB Type Pharmacy
Facility Name WALGREENS #09481
Street 12509 DORSETT RD
City MARYLAND HEIGHTS
State MO
ZIP 63043
Phone 314 434-4224
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/22/2023
Certificate Expiration Date 9/21/2025
Facility Type Pharmacy
Lab Director TAMMY P. HYLAN

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This page was last updated on: 6/4/2025