50D2084184 CLIA NUMBER - WALGREENS #15203

Laboratory Demographics

  • CLIA Code: 50D2084184
  • Facility Name: WALGREENS #15203
  • Facility Address: 26705 MAPLE VALLEY BLACK DIAMOND RD SE
    MAPLE VALLEY, WA
    ZIP 98038
  • Facility Phone: 425 578-9410
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THANG D. TRAN
  • NPI Number: 1801206057
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2084184
LAB Type Pharmacy
Facility Name WALGREENS #15203
Street 26705 MAPLE VALLEY BLACK DIAMOND RD SE
City MAPLE VALLEY
State WA
ZIP 98038
Phone 425 578-9410
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 THANG D. TRAN

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