05D2268807 CLIA NUMBER - CVS/PHARMACY #01483

Laboratory Demographics

  • CLIA Code: 05D2268807
  • Facility Name: CVS/PHARMACY #01483
  • Facility Address: 1599 TIBURON BLVD
    TIBURON, CA
    ZIP 94920
  • Facility Phone: 866 389-2727
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMAN BADAL
  • NPI Number: 1891065447
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2268807
LAB Type Pharmacy
Facility Name CVS/PHARMACY #01483
Street 1599 TIBURON BLVD
City TIBURON
State CA
ZIP 94920
Phone 866 389-2727
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 9/16/2024
Certificate Expiration Date 9/15/2026
Facility Type Pharmacy
Lab Director RAMAN BADAL

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