03D2011596 CLIA NUMBER - WALGREENS 02851

Laboratory Demographics

  • CLIA Code: 03D2011596
  • Facility Name: WALGREENS 02851
  • Facility Address: 7000 N 16TH ST STE 100
    PHOENIX, AZ
    ZIP 85020
  • Facility Phone: 602 943-3192
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RICHARD W. FENDORAK
  • NPI Number: 1356356695
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2011596
LAB Type Pharmacy
Facility Name WALGREENS 02851
Street 7000 N 16TH ST STE 100
City PHOENIX
State AZ
ZIP 85020
Phone 602 943-3192
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/11/2025
Certificate Expiration Date 8/10/2027
Facility Type Pharmacy
Lab Director RICHARD W. FENDORAK

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