37D2064277 CLIA NUMBER - WALGREENS #11095

Laboratory Demographics

  • CLIA Code: 37D2064277
  • Facility Name: WALGREENS #11095
  • Facility Address: 5901 NW 122ND ST
    OKLAHOMA CITY, OK
    ZIP 73142
  • Facility Phone: 405 722-1356
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JASON GIRARD
  • NPI Number: 1669630331
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2064277
LAB Type Pharmacy
Facility Name WALGREENS #11095
Street 5901 NW 122ND ST
City OKLAHOMA CITY
State OK
ZIP 73142
Phone 405 722-1356
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Pharmacy
Lab Director JASON GIRARD

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