03D2063111 CLIA NUMBER - WALGREENS #06063

Laboratory Demographics

  • CLIA Code: 03D2063111
  • Facility Name: WALGREENS #06063
  • Facility Address: 1825 W BETHANY HOME RD
    PHOENIX, AZ
    ZIP 85015
  • Facility Phone: 602 249-1285
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LOUIS J. BRIATTA
  • NPI Number: 1912913567
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063111
LAB Type Pharmacy
Facility Name WALGREENS #06063
Street 1825 W BETHANY HOME RD
City PHOENIX
State AZ
ZIP 85015
Phone 602 249-1285
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/19/2025
Certificate Expiration Date 4/18/2027
Facility Type Pharmacy
Lab Director LOUIS J. BRIATTA

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