50D2036711 CLIA NUMBER - WALGREENS #10395

Laboratory Demographics

  • CLIA Code: 50D2036711
  • Facility Name: WALGREENS #10395
  • Facility Address: 1610 NW LOUISIANA AVE
    CHEHALIS, WA
    ZIP 98532
  • Facility Phone: 360 740-1876
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES CLARK
  • NPI Number: 1760698393
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2036711
LAB Type Pharmacy
Facility Name WALGREENS #10395
Street 1610 NW LOUISIANA AVE
City CHEHALIS
State WA
ZIP 98532
Phone 360 740-1876
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/30/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director JAMES CLARK

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This page was last updated on: 6/4/2025