03D2012310 CLIA NUMBER - WALGREENS #06666

Laboratory Demographics

  • CLIA Code: 03D2012310
  • Facility Name: WALGREENS #06666
  • Facility Address: 2880 N CENTRE CT
    PRESCOTT VALLEY, AZ
    ZIP 86314
  • Facility Phone: 928 772-4938
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JUSTIN DINH
  • NPI Number: 1699780957
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2012310
LAB Type Pharmacy
Facility Name WALGREENS #06666
Street 2880 N CENTRE CT
City PRESCOTT VALLEY
State AZ
ZIP 86314
Phone 928 772-4938
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/19/2025
Certificate Expiration Date 3/18/2027
Facility Type Pharmacy
Lab Director JUSTIN DINH

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