03D2013073 CLIA NUMBER - WALGREENS #04102

Laboratory Demographics

  • CLIA Code: 03D2013073
  • Facility Name: WALGREENS #04102
  • Facility Address: 6767 E BROADWAY BLVD
    TUCSON, AZ
    ZIP 85710
  • Facility Phone: 520 290-0958
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTEN D. SHERWOOD
  • NPI Number: 1558377101
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2013073
LAB Type Pharmacy
Facility Name WALGREENS #04102
Street 6767 E BROADWAY BLVD
City TUCSON
State AZ
ZIP 85710
Phone 520 290-0958
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 KRISTEN D. SHERWOOD

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