05D2295567 CLIA NUMBER - WALGREENS 02961

Laboratory Demographics

  • CLIA Code: 05D2295567
  • Facility Name: WALGREENS 02961
  • Facility Address: 75 N HAM LN
    LODI, CA
    ZIP 95242
  • Facility Phone: 209 369-8575
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOANNE GARVEY
  • NPI Number: 1881609162
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295567
LAB Type Pharmacy
Facility Name WALGREENS 02961
Street 75 N HAM LN
City LODI
State CA
ZIP 95242
Phone 209 369-8575
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 JOANNE GARVEY

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