36D2064309 CLIA NUMBER - WALGREENS #11158

Laboratory Demographics

  • CLIA Code: 36D2064309
  • Facility Name: WALGREENS #11158
  • Facility Address: 1090 NORTHVIEW DR
    HILLSBORO, OH
    ZIP 45133
  • Facility Phone: 937 393-2307
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JESSE KRUSLING
  • NPI Number: 1255523577
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2064309
LAB Type Pharmacy
Facility Name WALGREENS #11158
Street 1090 NORTHVIEW DR
City HILLSBORO
State OH
ZIP 45133
Phone 937 393-2307
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director JESSE KRUSLING

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