03D2012004 CLIA NUMBER - WALGREENS #04103

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Laboratory Demographics

CLIA Number: 03D2012004

Facility Name: WALGREENS #04103

Facility Address:
10405 N LA CANADA DR
ORO VALLEY, AZ
ZIP 85737
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Facility Phone Number: 520 870-3002

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1033125406

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	03D2012004
LAB Type	Pharmacy
Facility Name	WALGREENS #04103
Street	10405 N LA CANADA DR
City	ORO VALLEY
State	AZ
ZIP	85737
Phone	520 870-3002
CertificateType	4
CertificateEffectiveDate	12/16/2022
CertificateExpirationDate	12/15/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024