03D2063102 CLIA NUMBER - WALGREENS #06533

Laboratory Demographics

  • CLIA Code: 03D2063102
  • Facility Name: WALGREENS #06533
  • Facility Address: 100 S BEELINE HWY
    PAYSON, AZ
    ZIP 85541
  • Facility Phone: 928 474-1599
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELLY L. ODEGAARD
  • NPI Number: 1033124375
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063102
LAB Type Pharmacy
Facility Name WALGREENS #06533
Street 100 S BEELINE HWY
City PAYSON
State AZ
ZIP 85541
Phone 928 474-1599
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/8/2025
Certificate Expiration Date 4/7/2027
Facility Type Pharmacy
Lab Director KELLY L. ODEGAARD

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