03D2175134 CLIA NUMBER - WESTERN DRUG & GENERAL STORE

Laboratory Demographics

  • CLIA Code: 03D2175134
  • Facility Name: WESTERN DRUG & GENERAL STORE
  • Facility Address: 106 E MAIN STREET
    SPRINGERVILLE, AZ
    ZIP 85938
  • Facility Phone: 928 333-2916
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHERYL MALONE
  • NPI Number: 1285749200
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2175134
LAB Type Pharmacy
Facility Name WESTERN DRUG & GENERAL STORE
Street 106 E MAIN STREET
City SPRINGERVILLE
State AZ
ZIP 85938
Phone 928 333-2916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director CHERYL MALONE

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