37D2012807 CLIA NUMBER - WALGREENS #03645

Laboratory Demographics

  • CLIA Code: 37D2012807
  • Facility Name: WALGREENS #03645
  • Facility Address: 101 N MIDWEST BLVD
    MIDWEST CITY, OK
    ZIP 73110
  • Facility Phone: 405 741-0857
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY M. GURTZ
  • NPI Number: 1871500751
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012807
LAB Type Pharmacy
Facility Name WALGREENS #03645
Street 101 N MIDWEST BLVD
City MIDWEST CITY
State OK
ZIP 73110
Phone 405 741-0857
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/9/2023
Certificate Expiration Date 11/8/2025
Facility Type Pharmacy
Lab Director JEREMY M. GURTZ

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