46D2060393 CLIA NUMBER - WALGREENS #11150

Laboratory Demographics

  • CLIA Code: 46D2060393
  • Facility Name: WALGREENS #11150
  • Facility Address: 850 S STATE ST
    OREM, UT
    ZIP 84097
  • Facility Phone: 801 616-5237
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDREW S. LIDDLE
  • NPI Number: 1225211972
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2060393
LAB Type Pharmacy
Facility Name WALGREENS #11150
Street 850 S STATE ST
City OREM
State UT
ZIP 84097
Phone 801 616-5237
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/22/2025
Certificate Expiration Date 1/21/2027
Facility Type Pharmacy
Lab Director ANDREW S. LIDDLE

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