32D2020481 CLIA NUMBER - WALGREENS #12004

Laboratory Demographics

  • CLIA Code: 32D2020481
  • Facility Name: WALGREENS #12004
  • Facility Address: 8011 VENTURA ST NE
    ALBUQUERQUE, NM
    ZIP 87109
  • Facility Phone: 505 217-2860
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFF BETTNER
  • NPI Number: 1093948754
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2020481
LAB Type Pharmacy
Facility Name WALGREENS #12004
Street 8011 VENTURA ST NE
City ALBUQUERQUE
State NM
ZIP 87109
Phone 505 217-2860
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 JEFF BETTNER

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