50D2036562 CLIA NUMBER - WALGREENS # 12275

Laboratory Demographics

  • CLIA Code: 50D2036562
  • Facility Name: WALGREENS # 12275
  • Facility Address: 610 W YAKIMA AVE
    YAKIMA, WA
    ZIP 98902
  • Facility Phone: 509 469-0246
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TODD RIDDLE
  • NPI Number: 1629214010
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2036562
LAB Type Pharmacy
Facility Name WALGREENS # 12275
Street 610 W YAKIMA AVE
City YAKIMA
State WA
ZIP 98902
Phone 509 469-0246
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 TODD RIDDLE

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