03D2011961 CLIA NUMBER - WALGREENS #04045

Laboratory Demographics

  • CLIA Code: 03D2011961
  • Facility Name: WALGREENS #04045
  • Facility Address: 4685 E GRANT RD
    TUCSON, AZ
    ZIP 85712
  • Facility Phone: 520 461-7710
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTIAN O. BUNYI
  • NPI Number: 1639184963
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2011961
LAB Type Pharmacy
Facility Name WALGREENS #04045
Street 4685 E GRANT RD
City TUCSON
State AZ
ZIP 85712
Phone 520 461-7710
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 KRISTIAN O. BUNYI

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