36D2222098 CLIA NUMBER - WALGREENS #04567

Laboratory Demographics

  • CLIA Code: 36D2222098
  • Facility Name: WALGREENS #04567
  • Facility Address: 6485 WILMINGTON PIKE
    DAYTON, OH
    ZIP 45459
  • Facility Phone: 937 433-5314
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PALAK SHAW
  • NPI Number: 1124033147
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2222098
LAB Type Pharmacy
Facility Name WALGREENS #04567
Street 6485 WILMINGTON PIKE
City DAYTON
State OH
ZIP 45459
Phone 937 433-5314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director PALAK SHAW

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