46D2288334 CLIA NUMBER - WALGREENS 17008

Laboratory Demographics

  • CLIA Code: 46D2288334
  • Facility Name: WALGREENS 17008
  • Facility Address: 4714 HOLLADAY BOULEVARD
    HOLLADAY, UT
    ZIP 84117
  • Facility Phone: 801 278-9767
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIELA JOTIC
  • NPI Number: 1700309739
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2288334
LAB Type Pharmacy
Facility Name WALGREENS 17008
Street 4714 HOLLADAY BOULEVARD
City HOLLADAY
State UT
ZIP 84117
Phone 801 278-9767
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/24/2025
Certificate Expiration Date 8/23/2027
Facility Type Pharmacy
Lab Director DANIELA JOTIC

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