05D2295170 CLIA NUMBER - WALGREENS 00887

Laboratory Demographics

  • CLIA Code: 05D2295170
  • Facility Name: WALGREENS 00887
  • Facility Address: 1524 POLK ST
    SAN FRANCISCO, CA
    ZIP 94109
  • Facility Phone: 415 673-4701
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANDY PANG
  • NPI Number: 1033125786
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295170
LAB Type Pharmacy
Facility Name WALGREENS 00887
Street 1524 POLK ST
City SAN FRANCISCO
State CA
ZIP 94109
Phone 415 673-4701
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 ANDY PANG

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