37D2225930 CLIA NUMBER - WALGREENS #03534

Laboratory Demographics

  • CLIA Code: 37D2225930
  • Facility Name: WALGREENS #03534
  • Facility Address: 4704 S ELM PL
    BROKEN ARROW, OK
    ZIP 74011
  • Facility Phone: 918 455-8308
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TAI NGUYEN
  • NPI Number: 1316952377
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 37D2225930
LAB Type Pharmacy
Facility Name WALGREENS #03534
Street 4704 S ELM PL
City BROKEN ARROW
State OK
ZIP 74011
Phone 918 455-8308
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/25/2025
Certificate Expiration Date 5/24/2027
Facility Type Pharmacy
Lab Director TAI NGUYEN

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