50D2060978 CLIA NUMBER - WALGREENS #01084

Laboratory Demographics

  • CLIA Code: 50D2060978
  • Facility Name: WALGREENS #01084
  • Facility Address: 808 W MAIN ST STE 101
    BATTLE GROUND, WA
    ZIP 98604
  • Facility Phone: 360 687-5133
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KATELYN A. WISDOM
  • NPI Number: 1730194721
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2060978
LAB Type Pharmacy
Facility Name WALGREENS #01084
Street 808 W MAIN ST STE 101
City BATTLE GROUND
State WA
ZIP 98604
Phone 360 687-5133
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 KATELYN A. WISDOM

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This page was last updated on: 3/20/2025