36D2242020 CLIA NUMBER - WALGREENS #06990

Laboratory Demographics

  • CLIA Code: 36D2242020
  • Facility Name: WALGREENS #06990
  • Facility Address: 183 E DAYTON YELLOW SPRINGS RD
    FAIRBORN, OH
    ZIP 45324
  • Facility Phone: 937 878-2889
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICOLE ESCHER
  • NPI Number: 1336154368
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 36D2242020
LAB Type Pharmacy
Facility Name WALGREENS #06990
Street 183 E DAYTON YELLOW SPRINGS RD
City FAIRBORN
State OH
ZIP 45324
Phone 937 878-2889
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/3/2023
Certificate Expiration Date 11/2/2025
Facility Type Pharmacy
Lab Director NICOLE ESCHER

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