28D2012917 CLIA NUMBER - WALGREENS 05874

Laboratory Demographics

  • CLIA Code: 28D2012917
  • Facility Name: WALGREENS 05874
  • Facility Address: 2630 PINE LAKE ROAD
    LINCOLN, NE
    ZIP 68512
  • Facility Phone: 402 421-0984
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW A. TOSCANO
  • NPI Number: 1356356307
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2012917
LAB Type Pharmacy
Facility Name WALGREENS 05874
Street 2630 PINE LAKE ROAD
City LINCOLN
State NE
ZIP 68512
Phone 402 421-0984
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/13/2025
Certificate Expiration Date 9/12/2027
Facility Type Pharmacy
Lab Director MATTHEW A. TOSCANO

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