05D2219602 CLIA NUMBER - WALGREENS #09516

Laboratory Demographics

  • CLIA Code: 05D2219602
  • Facility Name: WALGREENS #09516
  • Facility Address: 770 1ST ST
    GILROY, CA
    ZIP 95020
  • Facility Phone: 408 847-0983
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULIE F. DAC
  • NPI Number: 1831325943
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2219602
LAB Type Pharmacy
Facility Name WALGREENS #09516
Street 770 1ST ST
City GILROY
State CA
ZIP 95020
Phone 408 847-0983
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/6/2025
Certificate Expiration Date 4/5/2027
Facility Type Pharmacy
Lab Director JULIE F. DAC

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