50D2261154 CLIA NUMBER - HAGGEN PHARMACY #3450

Laboratory Demographics

  • CLIA Code: 50D2261154
  • Facility Name: HAGGEN PHARMACY #3450
  • Facility Address: 2601 E DIVISION ST
    MOUNT VERNON, WA
    ZIP 98274
  • Facility Phone: 360 848-6930
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN TEGART
  • NPI Number: 1144675513
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 50D2261154
LAB Type Pharmacy
Facility Name HAGGEN PHARMACY #3450
Street 2601 E DIVISION ST
City MOUNT VERNON
State WA
ZIP 98274
Phone 360 848-6930
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/26/2022
Certificate Expiration Date 4/4/2028
Facility Type Pharmacy
Lab Director SUSAN TEGART

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