05D2296814 CLIA NUMBER - WALGREENS 01179

Laboratory Demographics

  • CLIA Code: 05D2296814
  • Facility Name: WALGREENS 01179
  • Facility Address: 1795 E CAPITOL EXPY
    SAN JOSE, CA
    ZIP 95121
  • Facility Phone: 408 238-5890
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALEXANDRA TRAN
  • NPI Number: 1013922301
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2296814
LAB Type Pharmacy
Facility Name WALGREENS 01179
Street 1795 E CAPITOL EXPY
City SAN JOSE
State CA
ZIP 95121
Phone 408 238-5890
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/5/2024
Certificate Expiration Date 1/4/2026
Facility Type Pharmacy
Lab Director ALEXANDRA TRAN

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