03D0989014 CLIA NUMBER - WALGREENS STORE #04434

Laboratory Demographics

  • CLIA Code: 03D0989014
  • Facility Name: WALGREENS STORE #04434
  • Facility Address: 22280 N 67TH AVE
    GLENDALE, AZ
    ZIP 85310
  • Facility Phone: 623 572-8328
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHARAN RICE
  • NPI Number: 1033124383
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D0989014
LAB Type Pharmacy
Facility Name WALGREENS STORE #04434
Street 22280 N 67TH AVE
City GLENDALE
State AZ
ZIP 85310
Phone 623 572-8328
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director CHARAN RICE

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