26D2038807 CLIA NUMBER - WALGREENS #12307

Laboratory Demographics

  • CLIA Code: 26D2038807
  • Facility Name: WALGREENS #12307
  • Facility Address: 120 S BISHOP AVE
    ROLLA, MO
    ZIP 65401
  • Facility Phone: 573 426-3338
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CADEN A. WEIGL
  • NPI Number: 1235372749
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2038807
LAB Type Pharmacy
Facility Name WALGREENS #12307
Street 120 S BISHOP AVE
City ROLLA
State MO
ZIP 65401
Phone 573 426-3338
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/13/2025
Certificate Expiration Date 4/12/2027
Facility Type Pharmacy
Lab Director CADEN A. WEIGL

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