03D2072327 CLIA NUMBER - WALGREENS #03670

Laboratory Demographics

  • CLIA Code: 03D2072327
  • Facility Name: WALGREENS #03670
  • Facility Address: 1159 E SOUTHERN AVE
    MESA, AZ
    ZIP 85204
  • Facility Phone: 480 507-8709
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TASHA L. HENSTEIN
  • NPI Number: 1265447593
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2072327
LAB Type Pharmacy
Facility Name WALGREENS #03670
Street 1159 E SOUTHERN AVE
City MESA
State AZ
ZIP 85204
Phone 480 507-8709
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Pharmacy
Lab Director TASHA L. HENSTEIN

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