28D2221981 CLIA NUMBER - WALGREENS #11356

Laboratory Demographics

  • CLIA Code: 28D2221981
  • Facility Name: WALGREENS #11356
  • Facility Address: 11343 S 96TH ST
    PAPILLION, NE
    ZIP 68046
  • Facility Phone: 402 408-0761
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY J. VANA
  • NPI Number: 1093971301
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2221981
LAB Type Pharmacy
Facility Name WALGREENS #11356
Street 11343 S 96TH ST
City PAPILLION
State NE
ZIP 68046
Phone 402 408-0761
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/26/2023
Certificate Expiration Date 4/25/2025
Facility Type Pharmacy
Lab Director KELLY J. VANA

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This page was last updated on: 3/20/2025