03D2062286 CLIA NUMBER - WALGREENS #04018

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Laboratory Demographics

CLIA Number: 03D2062286

Facility Name: WALGREENS #04018

Facility Address:
2345 E BASELINE RD
GILBERT, AZ
ZIP 85234
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Facility Phone Number: 480 892-4978

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1083629315

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	03D2062286
LAB Type	Pharmacy
Facility Name	WALGREENS #04018
Street	2345 E BASELINE RD
City	GILBERT
State	AZ
ZIP	85234
Phone	480 892-4978
CertificateType	4
CertificateEffectiveDate	5/11/2023
CertificateExpirationDate	5/10/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024