03D2085759 CLIA NUMBER - WALGREENS #05039

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Laboratory Demographics

CLIA Number: 03D2085759

Facility Name: WALGREENS #05039

Facility Address:
746 W UNIVERSITY DRIVE
MESA, AZ
ZIP 85201
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Facility Phone Number: 480 688-6350

Facility Type: Pharmacy

Certificate Type: Waiver

NPI Number: 1396751707

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name	Field Value
CLIA Number	03D2085759
LAB Type	Pharmacy
Facility Name	WALGREENS #05039
Street	746 W UNIVERSITY DRIVE
City	MESA
State	AZ
ZIP	85201
Phone	480 688-6350
CertificateType	4
CertificateEffectiveDate	7/12/2023
CertificateExpirationDate	7/11/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024