05D2230008 CLIA NUMBER - WALGREENS #11242

Laboratory Demographics

  • CLIA Code: 05D2230008
  • Facility Name: WALGREENS #11242
  • Facility Address: 2020 WEST CLEVLAND AVE
    MADERA, CA
    ZIP 93637
  • Facility Phone: 559 664-9170
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THOAI VU
  • NPI Number: 1871740654
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2230008
LAB Type Pharmacy
Facility Name WALGREENS #11242
Street 2020 WEST CLEVLAND AVE
City MADERA
State CA
ZIP 93637
Phone 559 664-9170
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/19/2025
Certificate Expiration Date 7/18/2027
Facility Type Pharmacy
Lab Director THOAI VU

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