27D2041723 CLIA NUMBER - WALGREENS #10726

Laboratory Demographics

  • CLIA Code: 27D2041723
  • Facility Name: WALGREENS #10726
  • Facility Address: 2100 BROOKS ST
    MISSOULA, MT
    ZIP 59801
  • Facility Phone: 406 728-2089
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BARRY W. BODLE
  • NPI Number: 1790800399
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 27D2041723
LAB Type Pharmacy
Facility Name WALGREENS #10726
Street 2100 BROOKS ST
City MISSOULA
State MT
ZIP 59801
Phone 406 728-2089
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director BARRY W. BODLE

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