28D2013002 CLIA NUMBER - WALGREENS #07563

Laboratory Demographics

  • CLIA Code: 28D2013002
  • Facility Name: WALGREENS #07563
  • Facility Address: 8989 WEST DODGE ROAD
    OMAHA, NE
    ZIP 68114
  • Facility Phone: 402 393-2029
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY ZACKS
  • NPI Number: 1083629034
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2013002
LAB Type Pharmacy
Facility Name WALGREENS #07563
Street 8989 WEST DODGE ROAD
City OMAHA
State NE
ZIP 68114
Phone 402 393-2029
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director KELLY ZACKS

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This page was last updated on: 6/4/2025