50D2061032 CLIA NUMBER - WALGREENS #12168

Laboratory Demographics

  • CLIA Code: 50D2061032
  • Facility Name: WALGREENS #12168
  • Facility Address: 3929 KITSAP WAY
    BREMERTON, WA
    ZIP 98312
  • Facility Phone: 360 917-1041
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ASIA DAVIS
  • NPI Number: 1003047846
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2061032
LAB Type Pharmacy
Facility Name WALGREENS #12168
Street 3929 KITSAP WAY
City BREMERTON
State WA
ZIP 98312
Phone 360 917-1041
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 ASIA DAVIS

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