03D2064502 CLIA NUMBER - WALGREENS #12385

Laboratory Demographics

  • CLIA Code: 03D2064502
  • Facility Name: WALGREENS #12385
  • Facility Address: 475 W FINNIE FLAT RD
    CAMP VERDE, AZ
    ZIP 86322
  • Facility Phone: 928 239-3187
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MAREN M. CUSHMAN
  • NPI Number: 1982835617
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2064502
LAB Type Pharmacy
Facility Name WALGREENS #12385
Street 475 W FINNIE FLAT RD
City CAMP VERDE
State AZ
ZIP 86322
Phone 928 239-3187
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/16/2025
Certificate Expiration Date 4/15/2027
Facility Type Pharmacy
Lab Director MAREN M. CUSHMAN

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