37D2012867 CLIA NUMBER - WALGREENS #02361

Laboratory Demographics

  • CLIA Code: 37D2012867
  • Facility Name: WALGREENS #02361
  • Facility Address: 12802 E 96TH STREET NORTH
    OWASSO, OK
    ZIP 74055
  • Facility Phone: 918 272-7467
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1467536508
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2012867
LAB Type Pharmacy
Facility Name WALGREENS #02361
Street 12802 E 96TH STREET NORTH
City OWASSO
State OK
ZIP 74055
Phone 918 272-7467
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/25/2025
Certificate Expiration Date 3/24/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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