50D2038464 CLIA NUMBER - WALGREENS #09765

Laboratory Demographics

  • CLIA Code: 50D2038464
  • Facility Name: WALGREENS #09765
  • Facility Address: 5506 N ROAD 68
    PASCO, WA
    ZIP 99301
  • Facility Phone: 509 547-1789
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ERIC W. WIGMOSTA
  • NPI Number: 1841485141
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2038464
LAB Type Pharmacy
Facility Name WALGREENS #09765
Street 5506 N ROAD 68
City PASCO
State WA
ZIP 99301
Phone 509 547-1789
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ERIC W. WIGMOSTA

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