03D2013060 CLIA NUMBER - WALGREENS #04507

Laboratory Demographics

  • CLIA Code: 03D2013060
  • Facility Name: WALGREENS #04507
  • Facility Address: 15025 N THOMPSON PEAK PKWY
    SCOTTSDALE, AZ
    ZIP 85260
  • Facility Phone: 480 551-6429
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ADAM O. SHANAH
  • NPI Number: 1801801154
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2013060
LAB Type Pharmacy
Facility Name WALGREENS #04507
Street 15025 N THOMPSON PEAK PKWY
City SCOTTSDALE
State AZ
ZIP 85260
Phone 480 551-6429
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/7/2025
Certificate Expiration Date 4/6/2027
Facility Type Pharmacy
Lab Director ADAM O. SHANAH

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