29D2242956 CLIA NUMBER - WALGREENS #03915

Laboratory Demographics

  • CLIA Code: 29D2242956
  • Facility Name: WALGREENS #03915
  • Facility Address: 6401 W CHARLESTON BLVD, SUITE 100
    LAS VEGAS, NV
    ZIP 89146
  • Facility Phone: 702 259-7002
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MICHAEL DAUGHERTY
  • NPI Number: 1174538136
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 29D2242956
LAB Type Pharmacy
Facility Name WALGREENS #03915
Street 6401 W CHARLESTON BLVD, SUITE 100
City LAS VEGAS
State NV
ZIP 89146
Phone 702 259-7002
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director MICHAEL DAUGHERTY

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