03D1095569 CLIA NUMBER - WALGREENS 0813

Laboratory Demographics

  • CLIA Code: 03D1095569
  • Facility Name: WALGREENS 0813
  • Facility Address: 15442 N 99TH AVE
    SUN CITY, AZ
    ZIP 85351
  • Facility Phone: 623 974-2526
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MATTHEW L. GOH
  • NPI Number: 1093721649
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D1095569
LAB Type Pharmacy
Facility Name WALGREENS 0813
Street 15442 N 99TH AVE
City SUN CITY
State AZ
ZIP 85351
Phone 623 974-2526
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/2/2025
Certificate Expiration Date 10/1/2027
Facility Type Pharmacy
Lab Director MATTHEW L. GOH

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