53D2220184 CLIA NUMBER - WALGREENS #09092

Laboratory Demographics

  • CLIA Code: 53D2220184
  • Facility Name: WALGREENS #09092
  • Facility Address: 70 GATEWAY BLVD
    ROCK SPRINGS, WY
    ZIP 82901
  • Facility Phone: 307 382-2536
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TRAVIS FALLGREN
  • NPI Number: 1306851480
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2220184
LAB Type Pharmacy
Facility Name WALGREENS #09092
Street 70 GATEWAY BLVD
City ROCK SPRINGS
State WY
ZIP 82901
Phone 307 382-2536
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/9/2025
Certificate Expiration Date 4/8/2027
Facility Type Pharmacy
Lab Director TRAVIS FALLGREN

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