32D2224065 CLIA NUMBER - WALGREENS #13164

Laboratory Demographics

  • CLIA Code: 32D2224065
  • Facility Name: WALGREENS #13164
  • Facility Address: 9601 GIBSON BLVD SW
    ALBUQUERQUE, NM
    ZIP 87121
  • Facility Phone: 505 359-6000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: EDSON TARANGO-MORENO
  • NPI Number: 1093035891
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2224065
LAB Type Pharmacy
Facility Name WALGREENS #13164
Street 9601 GIBSON BLVD SW
City ALBUQUERQUE
State NM
ZIP 87121
Phone 505 359-6000
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 EDSON TARANGO-MORENO

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