03D2064503 CLIA NUMBER - WALGREENS #05567

Laboratory Demographics

  • CLIA Code: 03D2064503
  • Facility Name: WALGREENS #05567
  • Facility Address: 550 S MAIN ST
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 649-3850
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JAMES B. GALE
  • NPI Number: 1992710248
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2064503
LAB Type Pharmacy
Facility Name WALGREENS #05567
Street 550 S MAIN ST
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 649-3850
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/11/2025
Certificate Expiration Date 3/10/2027
Facility Type Pharmacy
Lab Director JAMES B. GALE

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