50D2036605 CLIA NUMBER - WALGREENS #9380

Laboratory Demographics

  • CLIA Code: 50D2036605
  • Facility Name: WALGREENS #9380
  • Facility Address: 6105 NE 114TH AVE
    VANCOUVER, WA
    ZIP 98662
  • Facility Phone: 360 254-3848
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DONALD L. HOSKISSON
  • NPI Number: 1104831197
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2036605
LAB Type Pharmacy
Facility Name WALGREENS #9380
Street 6105 NE 114TH AVE
City VANCOUVER
State WA
ZIP 98662
Phone 360 254-3848
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/24/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director DONALD L. HOSKISSON

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