29D2206511 CLIA NUMBER - WALGREENS #9902

Laboratory Demographics

  • CLIA Code: 29D2206511
  • Facility Name: WALGREENS #9902
  • Facility Address: 292 LOS ALTOS PKWY
    SPARKS, NV
    ZIP 89436
  • Facility Phone: 775 354-0104
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BUDDY X. FANG
  • NPI Number: 1235284548
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2206511
LAB Type Pharmacy
Facility Name WALGREENS #9902
Street 292 LOS ALTOS PKWY
City SPARKS
State NV
ZIP 89436
Phone 775 354-0104
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 BUDDY X. FANG

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