03D2008018 CLIA NUMBER - WALGREENS #04722

Laboratory Demographics

  • CLIA Code: 03D2008018
  • Facility Name: WALGREENS #04722
  • Facility Address: 4111 N 24TH ST
    PHOENIX, AZ
    ZIP 85016
  • Facility Phone: 602 245-5947
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JALPA A. PATEL-KAR
  • NPI Number: 1164771820
  • Taxonomy: 183500000X - Pharmacist

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CLIA Record

Field Name Field Value
CLIA Number 03D2008018
LAB Type Pharmacy
Facility Name WALGREENS #04722
Street 4111 N 24TH ST
City PHOENIX
State AZ
ZIP 85016
Phone 602 245-5947
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/16/2024
Certificate Expiration Date 12/15/2026
Facility Type Pharmacy
Lab Director JALPA A. PATEL-KAR

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