03D2063866 CLIA NUMBER - WALGREENS #04742

Laboratory Demographics

  • CLIA Code: 03D2063866
  • Facility Name: WALGREENS #04742
  • Facility Address: 8310 W DEER VALLEY RD
    PEORIA, AZ
    ZIP 85382
  • Facility Phone: 623 362-1960
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHARRON L. EGEA
  • NPI Number: 1609882349
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063866
LAB Type Pharmacy
Facility Name WALGREENS #04742
Street 8310 W DEER VALLEY RD
City PEORIA
State AZ
ZIP 85382
Phone 623 362-1960
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/21/2025
Certificate Expiration Date 6/20/2027
Facility Type Pharmacy
Lab Director SHARRON L. EGEA

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