32D1093558 CLIA NUMBER - WALGREENS #05350

Laboratory Demographics

  • CLIA Code: 32D1093558
  • Facility Name: WALGREENS #05350
  • Facility Address: 1835 N MAIN STREET
    ROSWELL, NM
    ZIP 88201
  • Facility Phone: 575 624-0423
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF BETTNER
  • NPI Number: 1801801709
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D1093558
LAB Type Pharmacy
Facility Name WALGREENS #05350
Street 1835 N MAIN STREET
City ROSWELL
State NM
ZIP 88201
Phone 575 624-0423
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/6/2025
Certificate Expiration Date 5/5/2027
Facility Type Pharmacy
Lab Director JEFF BETTNER

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