05D2297532 CLIA NUMBER - WALGREENS 02081

Laboratory Demographics

  • CLIA Code: 05D2297532
  • Facility Name: WALGREENS 02081
  • Facility Address: 1760 STORY RD
    SAN JOSE, CA
    ZIP 95122
  • Facility Phone: 408 251-9853
  • Facility Type: Home Health Agency
  • Facility Type: Waiver
  • Lab Director: THANH P. NGUYEN
  • NPI Number: 1144235474
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297532
LAB Type Home Health Agency
Facility Name WALGREENS 02081
Street 1760 STORY RD
City SAN JOSE
State CA
ZIP 95122
Phone 408 251-9853
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/17/2024
Certificate Expiration Date 1/16/2026
Facility Type Home Health Agency
Lab Director THANH P. NGUYEN

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