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05D2297590 CLIA NUMBER - WALGREENS 02939

Laboratory Demographics

CLIA Number: 05D2297590

Facility Name: WALGREENS 02939

Facility Address:
333 EL CAMINO REAL
SAN BRUNO, CA
ZIP 94066
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Facility Phone Number: 650 737-5735

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1699780973

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 05D2297590
LAB Type Pharmacy
Facility Name WALGREENS 02939
Street 333 EL CAMINO REAL
City SAN BRUNO
State CA
ZIP 94066
Phone 650 737-5735
CertificateType 4
CertificateEffectiveDate 1/18/2024
CertificateExpirationDate 1/17/2026
FacilityType Waiver

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