03D2087532 CLIA NUMBER - WALGREENS #09460

Laboratory Demographics

  • CLIA Code: 03D2087532
  • Facility Name: WALGREENS #09460
  • Facility Address: 40663 N GANTZEL RD
    SAN TAN VALLEY, AZ
    ZIP 85140
  • Facility Phone: 480 214-1680
  • Facility Type: Other - COVID-19 TESTING SITE
  • Facility Type: Waiver
  • Lab Director: MOBEEN MOSLEM
  • NPI Number: 1831328996
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2087532
LAB Type Other - COVID-19 TESTING SITE
Facility Name WALGREENS #09460
Street 40663 N GANTZEL RD
City SAN TAN VALLEY
State AZ
ZIP 85140
Phone 480 214-1680
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2025
Certificate Expiration Date 1/24/2027
Facility Type Other - COVID-19 TESTING SITE
Lab Director MOBEEN MOSLEM

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