32D2232671 CLIA NUMBER - WALGREENS #05157

Laboratory Demographics

  • CLIA Code: 32D2232671
  • Facility Name: WALGREENS #05157
  • Facility Address: 1115 N RIVERSIDE DR
    ESPANOLA, NM
    ZIP 87532
  • Facility Phone: 505 753-7005
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEREMY POCHATKO
  • NPI Number: 1629083522
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 32D2232671
LAB Type Pharmacy
Facility Name WALGREENS #05157
Street 1115 N RIVERSIDE DR
City ESPANOLA
State NM
ZIP 87532
Phone 505 753-7005
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 8/17/2023
Certificate Expiration Date 8/16/2025
Facility Type Pharmacy
Lab Director JEREMY POCHATKO

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This page was last updated on: 3/20/2025