26D2056394 CLIA NUMBER - WALGREENS #11711

Laboratory Demographics

  • CLIA Code: 26D2056394
  • Facility Name: WALGREENS #11711
  • Facility Address: 1530 LAFAYETTE AVE
    SAINT LOUIS, MO
    ZIP 63104
  • Facility Phone: 314 678-1039
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEX M. MCMULLEN
  • NPI Number: 1285967398
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2056394
LAB Type Pharmacy
Facility Name WALGREENS #11711
Street 1530 LAFAYETTE AVE
City SAINT LOUIS
State MO
ZIP 63104
Phone 314 678-1039
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director ALEX M. MCMULLEN

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