05D2220418 CLIA NUMBER - WALGREENS #09955

Laboratory Demographics

  • CLIA Code: 05D2220418
  • Facility Name: WALGREENS #09955
  • Facility Address: 995 SPERRY AVE
    PATTERSON, CA
    ZIP 95363
  • Facility Phone: 209 894-3700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HYUNSEUN CHO
  • NPI Number: 1942538871
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2220418
LAB Type Pharmacy
Facility Name WALGREENS #09955
Street 995 SPERRY AVE
City PATTERSON
State CA
ZIP 95363
Phone 209 894-3700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/12/2025
Certificate Expiration Date 4/11/2027
Facility Type Pharmacy
Lab Director HYUNSEUN CHO

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