37D2029810 CLIA NUMBER - WALGREEN #09874

Laboratory Demographics

  • CLIA Code: 37D2029810
  • Facility Name: WALGREEN #09874
  • Facility Address: 115 W 3RD STREET
    ELK CITY, OK
    ZIP 73644
  • Facility Phone: 580 225-4418
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1881609865
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2029810
LAB Type Pharmacy
Facility Name WALGREEN #09874
Street 115 W 3RD STREET
City ELK CITY
State OK
ZIP 73644
Phone 580 225-4418
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director DYLAN HANCIN

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This page was last updated on: 3/20/2025