46D2060374 CLIA NUMBER - WALGREENS #01776

Laboratory Demographics

  • CLIA Code: 46D2060374
  • Facility Name: WALGREENS #01776
  • Facility Address: 815 W STATE RD
    PLEASANT GROVE, UT
    ZIP 84062
  • Facility Phone: 801 922-4256
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SPENCER A. GRAHAM
  • NPI Number: 1588679526
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2060374
LAB Type Pharmacy
Facility Name WALGREENS #01776
Street 815 W STATE RD
City PLEASANT GROVE
State UT
ZIP 84062
Phone 801 922-4256
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2025
Certificate Expiration Date 3/21/2027
Facility Type Pharmacy
Lab Director SPENCER A. GRAHAM

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