46D2067463 CLIA NUMBER - WALGREENS #12294

Laboratory Demographics

  • CLIA Code: 46D2067463
  • Facility Name: WALGREENS #12294
  • Facility Address: 176 E 13800 S
    DRAPER, UT
    ZIP 84020
  • Facility Phone: 801 307-1003
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHAD C. JOLLEY
  • NPI Number: 1922238237
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2067463
LAB Type Pharmacy
Facility Name WALGREENS #12294
Street 176 E 13800 S
City DRAPER
State UT
ZIP 84020
Phone 801 307-1003
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/17/2024
Certificate Expiration Date 12/16/2026
Facility Type Pharmacy
Lab Director CHAD C. JOLLEY

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