26D2056312 CLIA NUMBER - WALGREENS 01679

Laboratory Demographics

  • CLIA Code: 26D2056312
  • Facility Name: WALGREENS 01679
  • Facility Address: 6411 GRAVOIS AVE
    SAINT LOUIS, MO
    ZIP 63116
  • Facility Phone: 314 832-3650
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RANIA D. DAHOUDI
  • NPI Number: 1336155894
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2056312
LAB Type Pharmacy
Facility Name WALGREENS 01679
Street 6411 GRAVOIS AVE
City SAINT LOUIS
State MO
ZIP 63116
Phone 314 832-3650
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/30/2023
Certificate Expiration Date 10/29/2025
Facility Type Pharmacy
Lab Director RANIA D. DAHOUDI

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