50D2013501 CLIA NUMBER - WALGREENS #05697

Laboratory Demographics

  • CLIA Code: 50D2013501
  • Facility Name: WALGREENS #05697
  • Facility Address: 15225 PACIFIC AVE S
    TACOMA, WA
    ZIP 98444
  • Facility Phone: 253 538-6916
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JENNIFER MANN
  • NPI Number: 1225045123
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2013501
LAB Type Pharmacy
Facility Name WALGREENS #05697
Street 15225 PACIFIC AVE S
City TACOMA
State WA
ZIP 98444
Phone 253 538-6916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JENNIFER MANN

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