36D2011626 CLIA NUMBER - WALGREENS #07523

Laboratory Demographics

  • CLIA Code: 36D2011626
  • Facility Name: WALGREENS #07523
  • Facility Address: 5690 W BROAD STREET
    GALLOWAY, OH
    ZIP 43119
  • Facility Phone: 614 870-7816
  • Facility Type: Other - COVID-19 TEST SITE
  • Facility Type: Waiver
  • Lab Director: BRADLEY BOLYARD
  • NPI Number: 1518972553
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2011626
LAB Type Other - COVID-19 TEST SITE
Facility Name WALGREENS #07523
Street 5690 W BROAD STREET
City GALLOWAY
State OH
ZIP 43119
Phone 614 870-7816
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2024
Certificate Expiration Date 12/13/2026
Facility Type Other - COVID-19 TEST SITE
Lab Director BRADLEY BOLYARD

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