05D2295570 CLIA NUMBER - WALGREENS 02902

Laboratory Demographics

  • CLIA Code: 05D2295570
  • Facility Name: WALGREENS 02902
  • Facility Address: 2101 E HATCH RD
    MODESTO, CA
    ZIP 95351
  • Facility Phone: 209 538-8268
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MANMEET SINGH
  • NPI Number: 1952317513
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295570
LAB Type Pharmacy
Facility Name WALGREENS 02902
Street 2101 E HATCH RD
City MODESTO
State CA
ZIP 95351
Phone 209 538-8268
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 MANMEET SINGH

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This page was last updated on: 6/4/2025