03D2008004 CLIA NUMBER - WALGREENS #04077

Laboratory Demographics

  • CLIA Code: 03D2008004
  • Facility Name: WALGREENS #04077
  • Facility Address: 3005 E RIGGS RD
    CHANDLER, AZ
    ZIP 85249
  • Facility Phone: 480 214-1402
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANIMESH TIWARI
  • NPI Number: 1346256708
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2008004
LAB Type Pharmacy
Facility Name WALGREENS #04077
Street 3005 E RIGGS RD
City CHANDLER
State AZ
ZIP 85249
Phone 480 214-1402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2023
Certificate Expiration Date 7/7/2025
Facility Type Pharmacy
Lab Director ANIMESH TIWARI

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This page was last updated on: 6/4/2025