05D2223011 CLIA NUMBER - WALGREENS #09702

Laboratory Demographics

  • CLIA Code: 05D2223011
  • Facility Name: WALGREENS #09702
  • Facility Address: 5785 N 1ST ST
    FRESNO, CA
    ZIP 93710
  • Facility Phone: 559 440-0152
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MINYAHIL A. WONDHIM
  • NPI Number: 1538374392
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2223011
LAB Type Pharmacy
Facility Name WALGREENS #09702
Street 5785 N 1ST ST
City FRESNO
State CA
ZIP 93710
Phone 559 440-0152
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/3/2025
Certificate Expiration Date 5/2/2027
Facility Type Pharmacy
Lab Director MINYAHIL A. WONDHIM

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