05D2295164 CLIA NUMBER - WALGREENS 00689

Laboratory Demographics

  • CLIA Code: 05D2295164
  • Facility Name: WALGREENS 00689
  • Facility Address: 121 E EL CAMINO REAL
    MOUNTAIN VIEW, CA
    ZIP 94040
  • Facility Phone: 650 961-7555
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DIVYA ADMAL
  • NPI Number: 1962417238
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295164
LAB Type Pharmacy
Facility Name WALGREENS 00689
Street 121 E EL CAMINO REAL
City MOUNTAIN VIEW
State CA
ZIP 94040
Phone 650 961-7555
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/6/2023
Certificate Expiration Date 12/5/2025
Facility Type Pharmacy
Lab Director DIVYA ADMAL

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