03D2285505 CLIA NUMBER - ARIZONA CVS STORES, LLC DBA CVS/PHARMACY #09319

Laboratory Demographics

  • CLIA Code: 03D2285505
  • Facility Name: ARIZONA CVS STORES, LLC DBA CVS/PHARMACY #09319
  • Facility Address: 1179 S STATE ROUTE 260
    COTTONWOOD, AZ
    ZIP 86326
  • Facility Phone: 928 634-2147
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: PETER RELLA
  • NPI Number: 1144264490
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2285505
LAB Type Pharmacy
Facility Name ARIZONA CVS STORES, LLC DBA CVS/PHARMACY #09319
Street 1179 S STATE ROUTE 260
City COTTONWOOD
State AZ
ZIP 86326
Phone 928 634-2147
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/13/2025
Certificate Expiration Date 7/12/2027
Facility Type Pharmacy
Lab Director PETER RELLA

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