46D2029598 CLIA NUMBER - WALGREENS #12480

Laboratory Demographics

  • CLIA Code: 46D2029598
  • Facility Name: WALGREENS #12480
  • Facility Address: 1316 W HIGHWAY 40
    VERNAL, UT
    ZIP 84078
  • Facility Phone: 435 789-7936
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RYAN P. LONG
  • NPI Number: 1770720484
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2029598
LAB Type Pharmacy
Facility Name WALGREENS #12480
Street 1316 W HIGHWAY 40
City VERNAL
State UT
ZIP 84078
Phone 435 789-7936
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director RYAN P. LONG

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