46D2309371 CLIA NUMBER - WALGREENS 19168

Laboratory Demographics

  • CLIA Code: 46D2309371
  • Facility Name: WALGREENS 19168
  • Facility Address: 950 IRON HORSE DRIVE
    PARK CITY, UT
    ZIP 84060
  • Facility Phone: 435 649-9621
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ROBERT J. HANSEN
  • NPI Number: 1538682695
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 46D2309371
LAB Type Pharmacy
Facility Name WALGREENS 19168
Street 950 IRON HORSE DRIVE
City PARK CITY
State UT
ZIP 84060
Phone 435 649-9621
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2024
Certificate Expiration Date 8/13/2026
Facility Type Pharmacy
Lab Director ROBERT J. HANSEN

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