03D2062296 CLIA NUMBER - WALGREENS #13870

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Laboratory Demographics

CLIA Number: 03D2062296

Facility Name: WALGREENS #13870

Facility Address:
4875 E ELLIOT RD
PHOENIX, AZ
ZIP 85044
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Facility Phone Number: 480 496-0019

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1164830790

Taxonomy: 183500000X - Pharmacist
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

CLIA Record

Field Name	Field Value
CLIA Number	03D2062296
LAB Type	Pharmacy
Facility Name	WALGREENS #13870
Street	4875 E ELLIOT RD
City	PHOENIX
State	AZ
ZIP	85044
Phone	480 496-0019
CertificateType	4
CertificateEffectiveDate	7/8/2023
CertificateExpirationDate	7/7/2025
FacilityType	Waiver

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