03D2011673 CLIA NUMBER - WALGREENS #04139

Laboratory Demographics

  • CLIA Code: 03D2011673
  • Facility Name: WALGREENS #04139
  • Facility Address: 3450 W DUNLAP AVE
    PHOENIX, AZ
    ZIP 85051
  • Facility Phone: 602 973-0971
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DAVID KNIGHTES
  • NPI Number: 1356356687
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2011673
LAB Type Pharmacy
Facility Name WALGREENS #04139
Street 3450 W DUNLAP AVE
City PHOENIX
State AZ
ZIP 85051
Phone 602 973-0971
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 DAVID KNIGHTES

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