03D2326827 CLIA NUMBER - MEDISOL PHARMACY

Laboratory Demographics

  • CLIA Code: 03D2326827
  • Facility Name: MEDISOL PHARMACY
  • Facility Address: 6666 W PEORIA AVE STE 101
    GLENDALE, AZ
    ZIP 85302
  • Facility Phone: 623 299-8054
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: STANISLAV A. SAZONOV
  • NPI Number: 1659139038
  • Taxonomy: 3336C0003X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 03D2326827
LAB Type Pharmacy
Facility Name MEDISOL PHARMACY
Street 6666 W PEORIA AVE STE 101
City GLENDALE
State AZ
ZIP 85302
Phone 623 299-8054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/10/2025
Certificate Expiration Date 7/9/2027
Facility Type Pharmacy
Lab Director STANISLAV A. SAZONOV

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