36D2230699 CLIA NUMBER - WALGREENS #12083

Laboratory Demographics

  • CLIA Code: 36D2230699
  • Facility Name: WALGREENS #12083
  • Facility Address: 1444 W 5TH AVE
    GRANDVIEW HEIGHTS, OH
    ZIP 43212
  • Facility Phone: 614 486-3308
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SYLVIA FOLMER
  • NPI Number: 1457591513
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2230699
LAB Type Pharmacy
Facility Name WALGREENS #12083
Street 1444 W 5TH AVE
City GRANDVIEW HEIGHTS
State OH
ZIP 43212
Phone 614 486-3308
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/27/2023
Certificate Expiration Date 7/26/2025
Facility Type Pharmacy
Lab Director SYLVIA FOLMER

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This page was last updated on: 6/4/2025