28D2023645 CLIA NUMBER - WALGREENS #12405

Laboratory Demographics

  • CLIA Code: 28D2023645
  • Facility Name: WALGREENS #12405
  • Facility Address: 102 E PHILIP AVENUE
    NORTH PLATTE, NE
    ZIP 69101
  • Facility Phone: 308 532-4303
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MS. JESSICA M. SIEGEL
  • NPI Number: 1588994172
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2023645
LAB Type Pharmacy
Facility Name WALGREENS #12405
Street 102 E PHILIP AVENUE
City NORTH PLATTE
State NE
ZIP 69101
Phone 308 532-4303
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/21/2025
Certificate Expiration Date 5/20/2027
Facility Type Pharmacy
Lab Director MS. JESSICA M. SIEGEL

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