50D2013673 CLIA NUMBER - WALGREENS #03518

Laboratory Demographics

  • CLIA Code: 50D2013673
  • Facility Name: WALGREENS #03518
  • Facility Address: 25605 104TH AVE SE
    KENT, WA
    ZIP 98030
  • Facility Phone: 253 813-6968
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YOSEF H. WOGER
  • NPI Number: 1285649244
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2013673
LAB Type Pharmacy
Facility Name WALGREENS #03518
Street 25605 104TH AVE SE
City KENT
State WA
ZIP 98030
Phone 253 813-6968
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director YOSEF H. WOGER

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