50D2038467 CLIA NUMBER - WALGREENS #10107

Laboratory Demographics

  • CLIA Code: 50D2038467
  • Facility Name: WALGREENS #10107
  • Facility Address: 633 W TIETAN ST
    WALLA WALLA, WA
    ZIP 99362
  • Facility Phone: (509) 529-1570
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DEEPA BHATT
  • NPI Number: 1407949068
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2038467
LAB Type Pharmacy
Facility Name WALGREENS #10107
Street 633 W TIETAN ST
City WALLA WALLA
State WA
ZIP 99362
Phone 5095291570
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/14/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director DEEPA BHATT

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This page was last updated on: 5/18/2026