36D2022545 CLIA NUMBER - WALGREENS #09904

Laboratory Demographics

  • CLIA Code: 36D2022545
  • Facility Name: WALGREENS #09904
  • Facility Address: 5383 CEMETARY ROAD
    HILLIARD, OH
    ZIP 43026
  • Facility Phone: 614 771-7493
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN R. TOOTLE
  • NPI Number: 1023139904
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2022545
LAB Type Pharmacy
Facility Name WALGREENS #09904
Street 5383 CEMETARY ROAD
City HILLIARD
State OH
ZIP 43026
Phone 614 771-7493
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/8/2025
Certificate Expiration Date 3/7/2027
Facility Type Pharmacy
Lab Director BRIAN R. TOOTLE

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