26D2290243 CLIA NUMBER - WALGREENS 15731

Laboratory Demographics

  • CLIA Code: 26D2290243
  • Facility Name: WALGREENS 15731
  • Facility Address: 101 N BUSINESS 60
    MANSFIELD, MO
    ZIP 65704
  • Facility Phone: 417 924-8877
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WENDY L. VLIETSTRA
  • NPI Number: 1184761108
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 26D2290243
LAB Type Pharmacy
Facility Name WALGREENS 15731
Street 101 N BUSINESS 60
City MANSFIELD
State MO
ZIP 65704
Phone 417 924-8877
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 WENDY L. VLIETSTRA

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