36D2011446 CLIA NUMBER - WALGREENS #04245

Laboratory Demographics

  • CLIA Code: 36D2011446
  • Facility Name: WALGREENS #04245
  • Facility Address: 5403 NORTH BEND ROAD
    CINCINNATI, OH
    ZIP 45247
  • Facility Phone: 513 662-1459
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY A. FISK
  • NPI Number: 1417962416
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2011446
LAB Type Pharmacy
Facility Name WALGREENS #04245
Street 5403 NORTH BEND ROAD
City CINCINNATI
State OH
ZIP 45247
Phone 513 662-1459
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/21/2025
Certificate Expiration Date 10/20/2027
Facility Type Pharmacy
Lab Director KELLY A. FISK

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