03D2008006 CLIA NUMBER - WALGREENS #04435

Laboratory Demographics

  • CLIA Code: 03D2008006
  • Facility Name: WALGREENS #04435
  • Facility Address: 4420 E BROWN RD
    MESA, AZ
    ZIP 85205
  • Facility Phone: 480 396-8193
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SUSAN M. MCCONNELL
  • NPI Number: 1962584656
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2008006
LAB Type Pharmacy
Facility Name WALGREENS #04435
Street 4420 E BROWN RD
City MESA
State AZ
ZIP 85205
Phone 480 396-8193
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director SUSAN M. MCCONNELL

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