03D2056544 CLIA NUMBER - WALGREENS #06729

Laboratory Demographics

  • CLIA Code: 03D2056544
  • Facility Name: WALGREENS #06729
  • Facility Address: 10929 E DYNAMITE BLVD
    SCOTTSDALE, AZ
    ZIP 85262
  • Facility Phone: 480 538-9313
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAXIM PRENTICE
  • NPI Number: 1669488300
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2056544
LAB Type Pharmacy
Facility Name WALGREENS #06729
Street 10929 E DYNAMITE BLVD
City SCOTTSDALE
State AZ
ZIP 85262
Phone 480 538-9313
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2023
Certificate Expiration Date 7/12/2025
Facility Type Pharmacy
Lab Director MAXIM PRENTICE

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This page was last updated on: 6/4/2025