32D2084035 CLIA NUMBER - WALGREENS #15607

Laboratory Demographics

  • CLIA Code: 32D2084035
  • Facility Name: WALGREENS #15607
  • Facility Address: 1509 E SANTA FE AVENUE
    GRANTS, NM
    ZIP 87020
  • Facility Phone: 505 658-3107
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSEPH CORBO
  • NPI Number: 1326450602
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2084035
LAB Type Pharmacy
Facility Name WALGREENS #15607
Street 1509 E SANTA FE AVENUE
City GRANTS
State NM
ZIP 87020
Phone 505 658-3107
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/18/2023
Certificate Expiration Date 11/17/2025
Facility Type Pharmacy
Lab Director JOSEPH CORBO

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