03D2064142 CLIA NUMBER - WALGREENS 02555

Laboratory Demographics

  • CLIA Code: 03D2064142
  • Facility Name: WALGREENS 02555
  • Facility Address: 178 E SHELDON ST
    PRESCOTT, AZ
    ZIP 86301
  • Facility Phone: 928 776-1936
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALLISON N. KREUTZBERG
  • NPI Number: 1669487906
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2064142
LAB Type Pharmacy
Facility Name WALGREENS 02555
Street 178 E SHELDON ST
City PRESCOTT
State AZ
ZIP 86301
Phone 928 776-1936
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/14/2025
Certificate Expiration Date 8/13/2027
Facility Type Pharmacy
Lab Director ALLISON N. KREUTZBERG

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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