03D2112582 CLIA NUMBER - ALBERTSONS PHARMACY #0197

Laboratory Demographics

  • CLIA Code: 03D2112582
  • Facility Name: ALBERTSONS PHARMACY #0197
  • Facility Address: 11475 E VIA LINDA
    SCOTTSDALE, AZ
    ZIP 85259
  • Facility Phone: 480 657-8968
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRIAN BROUILLETTE
  • NPI Number: 1811354095
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2112582
LAB Type Pharmacy
Facility Name ALBERTSONS PHARMACY #0197
Street 11475 E VIA LINDA
City SCOTTSDALE
State AZ
ZIP 85259
Phone 480 657-8968
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2024
Certificate Expiration Date 5/2/2026
Facility Type Pharmacy
Lab Director BRIAN BROUILLETTE

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