05D2259466 CLIA NUMBER - WALGREENS #15947

Laboratory Demographics

  • CLIA Code: 05D2259466
  • Facility Name: WALGREENS #15947
  • Facility Address: 13691 SAN PABLO AVE
    SAN PABLO, CA
    ZIP 94806
  • Facility Phone: 510 233-9467
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: NICHOLAS BENZSCHAWEL
  • NPI Number: 1457367005
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2259466
LAB Type Pharmacy
Facility Name WALGREENS #15947
Street 13691 SAN PABLO AVE
City SAN PABLO
State CA
ZIP 94806
Phone 510 233-9467
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 NICHOLAS BENZSCHAWEL

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