36D2224196 CLIA NUMBER - WALGREENS #13058

Laboratory Demographics

  • CLIA Code: 36D2224196
  • Facility Name: WALGREENS #13058
  • Facility Address: 35279 VINE ST
    WILLOWICK, OH
    ZIP 44095
  • Facility Phone: 440 918-0700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS A. STANZESKI
  • NPI Number: 1316952336
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2224196
LAB Type Pharmacy
Facility Name WALGREENS #13058
Street 35279 VINE ST
City WILLOWICK
State OH
ZIP 44095
Phone 440 918-0700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director NICHOLAS A. STANZESKI

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