36D2012138 CLIA NUMBER - WALGREENS #04976

Laboratory Demographics

  • CLIA Code: 36D2012138
  • Facility Name: WALGREENS #04976
  • Facility Address: 2710 SALEM AVENUE
    DAYTON, OH
    ZIP 45406
  • Facility Phone: 937 277-6022
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW BYRNES
  • NPI Number: 1962417980
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2012138
LAB Type Pharmacy
Facility Name WALGREENS #04976
Street 2710 SALEM AVENUE
City DAYTON
State OH
ZIP 45406
Phone 937 277-6022
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/13/2023
Certificate Expiration Date 5/12/2025
Facility Type Pharmacy
Lab Director ANDREW BYRNES

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This page was last updated on: 3/20/2025