03D2063137 CLIA NUMBER - WALGREENS #04020

Laboratory Demographics

  • CLIA Code: 03D2063137
  • Facility Name: WALGREENS #04020
  • Facility Address: 5895 W PEORIA AVE
    GLENDALE, AZ
    ZIP 85302
  • Facility Phone: 623 934-9152
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MOBIN NIKFEKR
  • NPI Number: 1306851654
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063137
LAB Type Pharmacy
Facility Name WALGREENS #04020
Street 5895 W PEORIA AVE
City GLENDALE
State AZ
ZIP 85302
Phone 623 934-9152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/12/2025
Certificate Expiration Date 5/11/2027
Facility Type Pharmacy
Lab Director MOBIN NIKFEKR

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