28D2052114 CLIA NUMBER - WALGREENS #06962

Laboratory Demographics

  • CLIA Code: 28D2052114
  • Facility Name: WALGREENS #06962
  • Facility Address: 3121 SOUTH 24TH STREET
    OMAHA, NE
    ZIP 68108
  • Facility Phone: 402 345-7178
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MR. BRIAN K. FOCHS
  • NPI Number: 1073528014
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2052114
LAB Type Pharmacy
Facility Name WALGREENS #06962
Street 3121 SOUTH 24TH STREET
City OMAHA
State NE
ZIP 68108
Phone 402 345-7178
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 MR. BRIAN K. FOCHS

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