05D2297703 CLIA NUMBER - WALGREENS 03296

Laboratory Demographics

  • CLIA Code: 05D2297703
  • Facility Name: WALGREENS 03296
  • Facility Address: 191 E 3RD AVE
    SAN MATEO, CA
    ZIP 94401
  • Facility Phone: 650 342-2723
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEVIN K. SUZUKI
  • NPI Number: 1053326330
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297703
LAB Type Pharmacy
Facility Name WALGREENS 03296
Street 191 E 3RD AVE
City SAN MATEO
State CA
ZIP 94401
Phone 650 342-2723
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/19/2024
Certificate Expiration Date 1/18/2026
Facility Type Pharmacy
Lab Director KEVIN K. SUZUKI

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