50D2030828 CLIA NUMBER - WALGREENS #02647

Laboratory Demographics

  • CLIA Code: 50D2030828
  • Facility Name: WALGREENS #02647
  • Facility Address: 200 E BROADWAY AVE
    MOSES LAKE, WA
    ZIP 98837
  • Facility Phone: 509 765-1217
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: WILLIAM BAUGHMAN
  • NPI Number: 1609016799
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 50D2030828
LAB Type Pharmacy
Facility Name WALGREENS #02647
Street 200 E BROADWAY AVE
City MOSES LAKE
State WA
ZIP 98837
Phone 509 765-1217
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director WILLIAM BAUGHMAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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