03D2013054 CLIA NUMBER - WALGREENS #11610

Laboratory Demographics

  • CLIA Code: 03D2013054
  • Facility Name: WALGREENS #11610
  • Facility Address: 2000 S MILL AVE
    TEMPE, AZ
    ZIP 85282
  • Facility Phone: 480 921-8013
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GAYOUNG KIM
  • NPI Number: 1528073863
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2013054
LAB Type Pharmacy
Facility Name WALGREENS #11610
Street 2000 S MILL AVE
City TEMPE
State AZ
ZIP 85282
Phone 480 921-8013
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director GAYOUNG KIM

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