03D2063879 CLIA NUMBER - WALGREENS #09571

Laboratory Demographics

  • CLIA Code: 03D2063879
  • Facility Name: WALGREENS #09571
  • Facility Address: 1020 N STATE ROUTE 89
    CHINO VALLEY, AZ
    ZIP 86323
  • Facility Phone: 928 636-2986
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: QUINN H. CANNON
  • NPI Number: 1992910574
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2063879
LAB Type Pharmacy
Facility Name WALGREENS #09571
Street 1020 N STATE ROUTE 89
City CHINO VALLEY
State AZ
ZIP 86323
Phone 928 636-2986
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/15/2025
Certificate Expiration Date 3/14/2027
Facility Type Pharmacy
Lab Director QUINN H. CANNON

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