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05D2295562 CLIA NUMBER - WALGREENS 02866

Laboratory Demographics

CLIA Number: 05D2295562

Facility Name: WALGREENS 02866

Facility Address:
1363 DIVISADERO ST
SAN FRANCISCO, CA
ZIP 94115
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Facility Phone Number: 415 931-9974

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1588670954

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 05D2295562
LAB Type Pharmacy
Facility Name WALGREENS 02866
Street 1363 DIVISADERO ST
City SAN FRANCISCO
State CA
ZIP 94115
Phone 415 931-9974
CertificateType 4
CertificateEffectiveDate 12/13/2023
CertificateExpirationDate 12/12/2025
FacilityType Waiver

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This page was last updated on: 4/23/2024