05D2222020 CLIA NUMBER - WALGREENS #15163

Laboratory Demographics

  • CLIA Code: 05D2222020
  • Facility Name: WALGREENS #15163
  • Facility Address: 1620 1ST ST
    LIVERMORE, CA
    ZIP 94550
  • Facility Phone: 925 724-0131
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NEERAJA C. POTLURI
  • NPI Number: 1851635759
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2222020
LAB Type Pharmacy
Facility Name WALGREENS #15163
Street 1620 1ST ST
City LIVERMORE
State CA
ZIP 94550
Phone 925 724-0131
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/27/2025
Certificate Expiration Date 4/26/2027
Facility Type Pharmacy
Lab Director NEERAJA C. POTLURI

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