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05D2296738 CLIA NUMBER - WALGREENS 04659

Laboratory Demographics

CLIA Number: 05D2296738

Facility Name: WALGREENS 04659

Facility Address:
164 W JACKSON ST
HAYWARD, CA
ZIP 94544
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Facility Phone Number: 510 784-0900

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1942216692

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 05D2296738
LAB Type Pharmacy
Facility Name WALGREENS 04659
Street 164 W JACKSON ST
City HAYWARD
State CA
ZIP 94544
Phone 510 784-0900
CertificateType 4
CertificateEffectiveDate 1/4/2024
CertificateExpirationDate 1/3/2026
FacilityType Waiver

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