50D2043129 CLIA NUMBER - WALGREENS #05817

Laboratory Demographics

  • CLIA Code: 50D2043129
  • Facility Name: WALGREENS #05817
  • Facility Address: 1708 W NORTHWEST BLVD
    SPOKANE, WA
    ZIP 99205
  • Facility Phone: 509 323-0309
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASHLEY K. BRUCK
  • NPI Number: 1902811961
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2043129
LAB Type Pharmacy
Facility Name WALGREENS #05817
Street 1708 W NORTHWEST BLVD
City SPOKANE
State WA
ZIP 99205
Phone 509 323-0309
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/18/2020
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director ASHLEY K. BRUCK

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