37D2219099 CLIA NUMBER - WALGREENS #04723

Laboratory Demographics

  • CLIA Code: 37D2219099
  • Facility Name: WALGREENS #04723
  • Facility Address: 11 W TAFT AVE
    SAPULPA, OK
    ZIP 74066
  • Facility Phone: 918 227-0878
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DYLAN HANCIN
  • NPI Number: 1073697736
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2219099
LAB Type Pharmacy
Facility Name WALGREENS #04723
Street 11 W TAFT AVE
City SAPULPA
State OK
ZIP 74066
Phone 918 227-0878
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