05D2296733 CLIA NUMBER - WALGREENS 04416

Laboratory Demographics

  • CLIA Code: 05D2296733
  • Facility Name: WALGREENS 04416
  • Facility Address: 20011 BOLLINGER RD
    CUPERTINO, CA
    ZIP 95014
  • Facility Phone: 408 973-8402
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DARRELL CHAN
  • NPI Number: 1841205176
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2296733
LAB Type Pharmacy
Facility Name WALGREENS 04416
Street 20011 BOLLINGER RD
City CUPERTINO
State CA
ZIP 95014
Phone 408 973-8402
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/4/2024
Certificate Expiration Date 1/3/2026
Facility Type Pharmacy
Lab Director DARRELL CHAN

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