28D2020694 CLIA NUMBER - WALGREENS # 12538

Laboratory Demographics

  • CLIA Code: 28D2020694
  • Facility Name: WALGREENS # 12538
  • Facility Address: 1230 NORTH WEBB ROAD
    GRAND ISLAND, NE
    ZIP 68803
  • Facility Phone: 308 384-2626
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAVENDER GEE
  • NPI Number: 1033345046
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2020694
LAB Type Pharmacy
Facility Name WALGREENS # 12538
Street 1230 NORTH WEBB ROAD
City GRAND ISLAND
State NE
ZIP 68803
Phone 308 384-2626
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 LAVENDER GEE

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