26D2056369 CLIA NUMBER - WALGREENS #05513

Laboratory Demographics

  • CLIA Code: 26D2056369
  • Facility Name: WALGREENS #05513
  • Facility Address: 11590 GRAVOIS ROAD
    SAINT LOUIS, MO
    ZIP 63126
  • Facility Phone: 314 849-6348
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SANEL IBRAHIMOVIC
  • NPI Number: 1528075538
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2056369
LAB Type Pharmacy
Facility Name WALGREENS #05513
Street 11590 GRAVOIS ROAD
City SAINT LOUIS
State MO
ZIP 63126
Phone 314 849-6348
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director SANEL IBRAHIMOVIC

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