37D2218934 CLIA NUMBER - WALGREENS #12009

Laboratory Demographics

  • CLIA Code: 37D2218934
  • Facility Name: WALGREENS #12009
  • Facility Address: 2120 S 4TH ST
    CHICKASHA, OK
    ZIP 73018
  • Facility Phone: 405 222-0278
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EFTON BRYON GLOVER
  • NPI Number: 1083873913
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2218934
LAB Type Pharmacy
Facility Name WALGREENS #12009
Street 2120 S 4TH ST
City CHICKASHA
State OK
ZIP 73018
Phone 405 222-0278
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/31/2025
Certificate Expiration Date 3/30/2027
Facility Type Pharmacy
Lab Director EFTON BRYON GLOVER

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