50D2060972 CLIA NUMBER - WALGREENS #5698

Laboratory Demographics

  • CLIA Code: 50D2060972
  • Facility Name: WALGREENS #5698
  • Facility Address: 3099 BETHEL RD SE
    PORT ORCHARD, WA
    ZIP 98366
  • Facility Phone: 360 876-5212
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FRANKLIN ANTONIO RODRIGUEZ MENDOZA
  • NPI Number: 1922013994
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2060972
LAB Type Pharmacy
Facility Name WALGREENS #5698
Street 3099 BETHEL RD SE
City PORT ORCHARD
State WA
ZIP 98366
Phone 360 876-5212
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 FRANKLIN ANTONIO RODRIGUEZ MENDOZA

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