37D2012069 CLIA NUMBER - WALGREENS #04066

Laboratory Demographics

  • CLIA Code: 37D2012069
  • Facility Name: WALGREENS #04066
  • Facility Address: 1099 GARTH BROOKS BLVD
    YUKON, OK
    ZIP 73099
  • Facility Phone: 405 350-1251
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1982619953
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012069
LAB Type Pharmacy
Facility Name WALGREENS #04066
Street 1099 GARTH BROOKS BLVD
City YUKON
State OK
ZIP 73099
Phone 405 350-1251
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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