28D2012918 CLIA NUMBER - WALGREENS 04753

Laboratory Demographics

  • CLIA Code: 28D2012918
  • Facility Name: WALGREENS 04753
  • Facility Address: 1404 SUPERIOR STREET
    LINCOLN, NE
    ZIP 68521
  • Facility Phone: 402 477-2622
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RACHEL M. CARRASCO
  • NPI Number: 1538174586
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2012918
LAB Type Pharmacy
Facility Name WALGREENS 04753
Street 1404 SUPERIOR STREET
City LINCOLN
State NE
ZIP 68521
Phone 402 477-2622
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 RACHEL M. CARRASCO

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