05D2259464 CLIA NUMBER - WALGREENS #10599

Laboratory Demographics

  • CLIA Code: 05D2259464
  • Facility Name: WALGREENS #10599
  • Facility Address: 4014 PLAZA GOLDORADO CIR
    CAMERON PARK, CA
    ZIP 95682
  • Facility Phone: 530 676-2095
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CATHY P. PHAM
  • NPI Number: 1326345174
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2259464
LAB Type Pharmacy
Facility Name WALGREENS #10599
Street 4014 PLAZA GOLDORADO CIR
City CAMERON PARK
State CA
ZIP 95682
Phone 530 676-2095
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 CATHY P. PHAM

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