27D2011347 CLIA NUMBER - WALGREENS #09351

Laboratory Demographics

  • CLIA Code: 27D2011347
  • Facility Name: WALGREENS #09351
  • Facility Address: 2527 N RESERVE ST
    MISSOULA, MT
    ZIP 59808
  • Facility Phone: 406 543-1163
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DUNAWAY DENTYN
  • NPI Number: 1629083662
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2011347
LAB Type Pharmacy
Facility Name WALGREENS #09351
Street 2527 N RESERVE ST
City MISSOULA
State MT
ZIP 59808
Phone 406 543-1163
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director DUNAWAY DENTYN

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