05D2297717 CLIA NUMBER - WALGREENS 04243

Laboratory Demographics

  • CLIA Code: 05D2297717
  • Facility Name: WALGREENS 04243
  • Facility Address: 980 E CYPRESS AVE
    REDDING, CA
    ZIP 96002
  • Facility Phone: 530 221-5028
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KEITH THOR
  • NPI Number: 1750396081
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297717
LAB Type Pharmacy
Facility Name WALGREENS 04243
Street 980 E CYPRESS AVE
City REDDING
State CA
ZIP 96002
Phone 530 221-5028
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 KEITH THOR

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