03D2013062 CLIA NUMBER - WALGREENS #06177

Laboratory Demographics

  • CLIA Code: 03D2013062
  • Facility Name: WALGREENS #06177
  • Facility Address: 1135 N MESA DR
    MESA, AZ
    ZIP 85201
  • Facility Phone: 480 898-8025
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRANDY GRIFFIN
  • NPI Number: 1023023363
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2013062
LAB Type Pharmacy
Facility Name WALGREENS #06177
Street 1135 N MESA DR
City MESA
State AZ
ZIP 85201
Phone 480 898-8025
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 BRANDY GRIFFIN

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