05D2295736 CLIA NUMBER - WALGREENS 03378

Laboratory Demographics

  • CLIA Code: 05D2295736
  • Facility Name: WALGREENS 03378
  • Facility Address: 1376 KOOSER RD
    SAN JOSE, CA
    ZIP 95118
  • Facility Phone: 408 448-2503
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMAL M. THAKARSEY
  • NPI Number: 1932114212
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2295736
LAB Type Pharmacy
Facility Name WALGREENS 03378
Street 1376 KOOSER RD
City SAN JOSE
State CA
ZIP 95118
Phone 408 448-2503
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 12/15/2023
Certificate Expiration Date 12/14/2025
Facility Type Pharmacy
Lab Director AMAL M. THAKARSEY

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