37D2012821 CLIA NUMBER - WALGREENS #03647

Laboratory Demographics

  • CLIA Code: 37D2012821
  • Facility Name: WALGREENS #03647
  • Facility Address: 100 12TH AVE NE
    NORMAN, OK
    ZIP 73071
  • Facility Phone: 405 329-2314
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1952619447
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012821
LAB Type Pharmacy
Facility Name WALGREENS #03647
Street 100 12TH AVE NE
City NORMAN
State OK
ZIP 73071
Phone 405 329-2314
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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