03D2064498 CLIA NUMBER - WALGREENS #04065

Laboratory Demographics

  • CLIA Code: 03D2064498
  • Facility Name: WALGREENS #04065
  • Facility Address: 1995 W STATE ROUTE 89A
    SEDONA, AZ
    ZIP 86336
  • Facility Phone: 928 282-3903
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TONI S. BURGOS
  • NPI Number: 1841205184
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 03D2064498
LAB Type Pharmacy
Facility Name WALGREENS #04065
Street 1995 W STATE ROUTE 89A
City SEDONA
State AZ
ZIP 86336
Phone 928 282-3903
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2025
Certificate Expiration Date 7/8/2027
Facility Type Pharmacy
Lab Director TONI S. BURGOS

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