05D2259463 CLIA NUMBER - WALGREENS #09048

Laboratory Demographics

  • CLIA Code: 05D2259463
  • Facility Name: WALGREENS #09048
  • Facility Address: 2595 E BIDWELL ST
    FOLSOM, CA
    ZIP 95630
  • Facility Phone: 916 817-6533
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VANG S. THAO
  • NPI Number: 1932116936
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2259463
LAB Type Pharmacy
Facility Name WALGREENS #09048
Street 2595 E BIDWELL ST
City FOLSOM
State CA
ZIP 95630
Phone 916 817-6533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2024
Certificate Expiration Date 5/4/2026
Facility Type Pharmacy
Lab Director VANG S. THAO

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