03D2064117 CLIA NUMBER - WALGREENS #09292

Laboratory Demographics

  • CLIA Code: 03D2064117
  • Facility Name: WALGREENS #09292
  • Facility Address: 1310 WILLOW CREEK RD
    PRESCOTT, AZ
    ZIP 86301
  • Facility Phone: 928 227-9965
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHRIS MWAI
  • NPI Number: 1427064898
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2064117
LAB Type Pharmacy
Facility Name WALGREENS #09292
Street 1310 WILLOW CREEK RD
City PRESCOTT
State AZ
ZIP 86301
Phone 928 227-9965
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director CHRIS MWAI

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