50D2013519 CLIA NUMBER - WALGREENS #09590

Laboratory Demographics

  • CLIA Code: 50D2013519
  • Facility Name: WALGREENS #09590
  • Facility Address: 5602 PACIFIC AVE
    TACOMA, WA
    ZIP 98408
  • Facility Phone: 253 203-0074
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA M. ITAI
  • NPI Number: 1285649277
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2013519
LAB Type Pharmacy
Facility Name WALGREENS #09590
Street 5602 PACIFIC AVE
City TACOMA
State WA
ZIP 98408
Phone 253 203-0074
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director AMANDA M. ITAI

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