32D2011487 CLIA NUMBER - WALGREENS #11360

Laboratory Demographics

  • CLIA Code: 32D2011487
  • Facility Name: WALGREENS #11360
  • Facility Address: 11200 MONTGOMERY BLVD NE #12
    ALBUQUERQUE, NM
    ZIP 87111
  • Facility Phone: 505 298-7477
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS A. KESTELL
  • NPI Number: 1285641183
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2011487
LAB Type Pharmacy
Facility Name WALGREENS #11360
Street 11200 MONTGOMERY BLVD NE #12
City ALBUQUERQUE
State NM
ZIP 87111
Phone 505 298-7477
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/11/2025
Certificate Expiration Date 5/10/2027
Facility Type Pharmacy
Lab Director NICHOLAS A. KESTELL

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