28D2223889 CLIA NUMBER - WALGREENS #11205

Laboratory Demographics

  • CLIA Code: 28D2223889
  • Facility Name: WALGREENS #11205
  • Facility Address: 6005 N 72ND STREET
    OMAHA, NE
    ZIP 68134
  • Facility Phone: 402 201-2729
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LACIE C. PECHA
  • NPI Number: 1538355805
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 28D2223889
LAB Type Pharmacy
Facility Name WALGREENS #11205
Street 6005 N 72ND STREET
City OMAHA
State NE
ZIP 68134
Phone 402 201-2729
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director LACIE C. PECHA

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