05D2295208 CLIA NUMBER - WALGREENS 02575

Laboratory Demographics

  • CLIA Code: 05D2295208
  • Facility Name: WALGREENS 02575
  • Facility Address: 2647 SPRINGS RD
    VALLEJO, CA
    ZIP 94591
  • Facility Phone: 707 557-5974
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALBERT QUENTELA
  • NPI Number: 1609881986
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295208
LAB Type Pharmacy
Facility Name WALGREENS 02575
Street 2647 SPRINGS RD
City VALLEJO
State CA
ZIP 94591
Phone 707 557-5974
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 ALBERT QUENTELA

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