46D2063246 CLIA NUMBER - WALGREENS #11524

Laboratory Demographics

  • CLIA Code: 46D2063246
  • Facility Name: WALGREENS #11524
  • Facility Address: 5627 W 13400 S
    HERRIMAN, UT
    ZIP 84096
  • Facility Phone: 801 307-1909
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHELLEY D. THOMAS
  • NPI Number: 1548432560
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2063246
LAB Type Pharmacy
Facility Name WALGREENS #11524
Street 5627 W 13400 S
City HERRIMAN
State UT
ZIP 84096
Phone 801 307-1909
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/23/2025
Certificate Expiration Date 3/22/2027
Facility Type Pharmacy
Lab Director SHELLEY D. THOMAS

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