03D2064496 CLIA NUMBER - WALGREENS #07933

Laboratory Demographics

  • CLIA Code: 03D2064496
  • Facility Name: WALGREENS #07933
  • Facility Address: 15514 W WADDELL RD
    SURPRISE, AZ
    ZIP 85379
  • Facility Phone: 623 215-0544
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KRISTA MANDUSIC
  • NPI Number: 1831104199
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2064496
LAB Type Pharmacy
Facility Name WALGREENS #07933
Street 15514 W WADDELL RD
City SURPRISE
State AZ
ZIP 85379
Phone 623 215-0544
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/14/2025
Certificate Expiration Date 5/13/2027
Facility Type Pharmacy
Lab Director KRISTA MANDUSIC

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