29D2206509 CLIA NUMBER - WALGREENS #04086

Laboratory Demographics

  • CLIA Code: 29D2206509
  • Facility Name: WALGREENS #04086
  • Facility Address: 4470 E BONANZA RD
    LAS VEGAS, NV
    ZIP 89110
  • Facility Phone: (702) 531-8006
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WITHANIA NEAL
  • NPI Number: 1255346219
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2206509
LAB Type Pharmacy
Facility Name WALGREENS #04086
Street 4470 E BONANZA RD
City LAS VEGAS
State NV
ZIP 89110
Phone 7025318006
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/21/2024
Certificate Expiration Date 12/20/2026
Facility Type Pharmacy
Lab Director WITHANIA NEAL

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This page was last updated on: 5/18/2026