03D2197790 CLIA NUMBER - FLAGSTAFF PHARMACY

Laboratory Demographics

  • CLIA Code: 03D2197790
  • Facility Name: FLAGSTAFF PHARMACY
  • Facility Address: 77 W FOREST AVE SUITE 104
    FLAGSTAFF, AZ
    ZIP 86001
  • Facility Phone: 928 773-2565
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YARI VALLE
  • NPI Number: 1649348442
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2197790
LAB Type Pharmacy
Facility Name FLAGSTAFF PHARMACY
Street 77 W FOREST AVE SUITE 104
City FLAGSTAFF
State AZ
ZIP 86001
Phone 928 773-2565
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/27/2024
Certificate Expiration Date 10/26/2026
Facility Type Pharmacy
Lab Director YARI VALLE

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