05D2223013 CLIA NUMBER - WALGREENS #10766

Laboratory Demographics

  • CLIA Code: 05D2223013
  • Facility Name: WALGREENS #10766
  • Facility Address: 2810 S TRACY BLVD
    TRACY, CA
    ZIP 95377
  • Facility Phone: 209 834-0248
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANGELA HUYNH
  • NPI Number: 1073831145
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2223013
LAB Type Pharmacy
Facility Name WALGREENS #10766
Street 2810 S TRACY BLVD
City TRACY
State CA
ZIP 95377
Phone 209 834-0248
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 ANGELA HUYNH

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