46D2060385 CLIA NUMBER - WALGREENS #09974

Laboratory Demographics

  • CLIA Code: 46D2060385
  • Facility Name: WALGREENS #09974
  • Facility Address: 420 S MAIN ST
    SPRINGVILLE, UT
    ZIP 84663
  • Facility Phone: 801 853-1214
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JINAH J. KIM
  • NPI Number: 1669487609
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2060385
LAB Type Pharmacy
Facility Name WALGREENS #09974
Street 420 S MAIN ST
City SPRINGVILLE
State UT
ZIP 84663
Phone 801 853-1214
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/24/2025
Certificate Expiration Date 3/23/2027
Facility Type Pharmacy
Lab Director JINAH J. KIM

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