53D2231646 CLIA NUMBER - WALGREENS #07462

Laboratory Demographics

  • CLIA Code: 53D2231646
  • Facility Name: WALGREENS #07462
  • Facility Address: 190 SE WYOMING BLVD
    CASPER, WY
    ZIP 82609
  • Facility Phone: 307 234-9184
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OPAL A. MACK
  • NPI Number: 1770598856
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 53D2231646
LAB Type Pharmacy
Facility Name WALGREENS #07462
Street 190 SE WYOMING BLVD
City CASPER
State WY
ZIP 82609
Phone 307 234-9184
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/4/2025
Certificate Expiration Date 8/3/2027
Facility Type Pharmacy
Lab Director OPAL A. MACK

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