38D2311791 CLIA NUMBER - WALGREENS 21434

Laboratory Demographics

  • CLIA Code: 38D2311791
  • Facility Name: WALGREENS 21434
  • Facility Address: 174 NE SAINT CHARLES WY
    PRINEVILLE, OR
    ZIP 97754
  • Facility Phone: 541 447-0395
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD T. LUTZ
  • NPI Number: 1790448298
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 38D2311791
LAB Type Pharmacy
Facility Name WALGREENS 21434
Street 174 NE SAINT CHARLES WY
City PRINEVILLE
State OR
ZIP 97754
Phone 541 447-0395
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/30/2024
Certificate Expiration Date 9/29/2026
Facility Type Pharmacy
Lab Director RICHARD T. LUTZ

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