46D2060390 CLIA NUMBER - WALGREENS #10552

Laboratory Demographics

  • CLIA Code: 46D2060390
  • Facility Name: WALGREENS #10552
  • Facility Address: 999 N MAIN ST
    LOGAN, UT
    ZIP 84321
  • Facility Phone: 435 227-1100
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAKOB SOUTH
  • NPI Number: 1699907402
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2060390
LAB Type Pharmacy
Facility Name WALGREENS #10552
Street 999 N MAIN ST
City LOGAN
State UT
ZIP 84321
Phone 435 227-1100
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 JAKOB SOUTH

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