03D2239548 CLIA NUMBER - WALGREENS #03245

Laboratory Demographics

  • CLIA Code: 03D2239548
  • Facility Name: WALGREENS #03245
  • Facility Address: 3487 N STOCKTON HILL RD
    KINGMAN, AZ
    ZIP 86409
  • Facility Phone: 928 692-1822
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BRAYDON C. LARSON
  • NPI Number: 1346255684
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2239548
LAB Type Pharmacy
Facility Name WALGREENS #03245
Street 3487 N STOCKTON HILL RD
City KINGMAN
State AZ
ZIP 86409
Phone 928 692-1822
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 10/12/2025
Certificate Expiration Date 10/11/2027
Facility Type Pharmacy
Lab Director BRAYDON C. LARSON

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