05D2293847 CLIA NUMBER - WALGREENS #04724

Laboratory Demographics

  • CLIA Code: 05D2293847
  • Facility Name: WALGREENS #04724
  • Facility Address: 3416 DEER VALLEY RD
    ANTIOCH, CA
    ZIP 94531
  • Facility Phone: 925 978-8000
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HUONG T. LAI
  • NPI Number: 1912912288
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2293847
LAB Type Pharmacy
Facility Name WALGREENS #04724
Street 3416 DEER VALLEY RD
City ANTIOCH
State CA
ZIP 94531
Phone 925 978-8000
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 11/15/2023
Certificate Expiration Date 11/14/2025
Facility Type Pharmacy
Lab Director HUONG T. LAI

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