28D2012922 CLIA NUMBER - WALGREENS #03467

Laboratory Demographics

  • CLIA Code: 28D2012922
  • Facility Name: WALGREENS #03467
  • Facility Address: 1515 WEST 2ND STREET
    GRAND ISLAND, NE
    ZIP 68801
  • Facility Phone: 308 384-8290
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMONA R. GATES
  • NPI Number: 1437164472
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2012922
LAB Type Pharmacy
Facility Name WALGREENS #03467
Street 1515 WEST 2ND STREET
City GRAND ISLAND
State NE
ZIP 68801
Phone 308 384-8290
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/28/2025
Certificate Expiration Date 4/27/2027
Facility Type Pharmacy
Lab Director RAMONA R. GATES

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