05D2063535 CLIA NUMBER - WALGREENS #09978

Laboratory Demographics

  • CLIA Code: 05D2063535
  • Facility Name: WALGREENS #09978
  • Facility Address: 6570 LONE TREE WAY
    BRENTWOOD, CA
    ZIP 94513
  • Facility Phone: 925 240-6043
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JEFFEREY CHAN
  • NPI Number: 1386859080
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2063535
LAB Type Pharmacy
Facility Name WALGREENS #09978
Street 6570 LONE TREE WAY
City BRENTWOOD
State CA
ZIP 94513
Phone 925 240-6043
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/9/2025
Certificate Expiration Date 9/8/2027
Facility Type Pharmacy
Lab Director JEFFEREY CHAN

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