50D2038517 CLIA NUMBER - WALGREENS # 11215

Laboratory Demographics

  • CLIA Code: 50D2038517
  • Facility Name: WALGREENS # 11215
  • Facility Address: 932 E FRONT ST
    PORT ANGELES, WA
    ZIP 98362
  • Facility Phone: 360 457-4456
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JI YOUNG PARK
  • NPI Number: 1700072972
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2038517
LAB Type Pharmacy
Facility Name WALGREENS # 11215
Street 932 E FRONT ST
City PORT ANGELES
State WA
ZIP 98362
Phone 360 457-4456
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 JI YOUNG PARK

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