05D2295551 CLIA NUMBER - WALGREENS 04170

Laboratory Demographics

  • CLIA Code: 05D2295551
  • Facility Name: WALGREENS 04170
  • Facility Address: 4200 ARDEN WAY
    SACRAMENTO, CA
    ZIP 95864
  • Facility Phone: 916 485-4069
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALSALIHI ABDULLA
  • NPI Number: 1942215231
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295551
LAB Type Pharmacy
Facility Name WALGREENS 04170
Street 4200 ARDEN WAY
City SACRAMENTO
State CA
ZIP 95864
Phone 916 485-4069
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/13/2023
Certificate Expiration Date 12/12/2025
Facility Type Pharmacy
Lab Director ALSALIHI ABDULLA

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