05D2297165 CLIA NUMBER - WALGREENS 05006

Laboratory Demographics

  • CLIA Code: 05D2297165
  • Facility Name: WALGREENS 05006
  • Facility Address: 4070 S EL CAMINO REAL
    SAN MATEO, CA
    ZIP 94403
  • Facility Phone: 650 212-4600
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: DANIEL H OH
  • NPI Number: 1003821372
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297165
LAB Type Pharmacy
Facility Name WALGREENS 05006
Street 4070 S EL CAMINO REAL
City SAN MATEO
State CA
ZIP 94403
Phone 650 212-4600
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/11/2024
Certificate Expiration Date 1/10/2026
Facility Type Pharmacy
Lab Director DANIEL H OH

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