37D2012863 CLIA NUMBER - WALGREENS #04269

Laboratory Demographics

  • CLIA Code: 37D2012863
  • Facility Name: WALGREENS #04269
  • Facility Address: 1427 HARRISON STREET
    SHAWNEE, OK
    ZIP 74801
  • Facility Phone: 405 273-8520
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1609881671
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012863
LAB Type Pharmacy
Facility Name WALGREENS #04269
Street 1427 HARRISON STREET
City SHAWNEE
State OK
ZIP 74801
Phone 405 273-8520
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/1/2025
Certificate Expiration Date 3/31/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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