05D2297832 CLIA NUMBER - WALGREENS 04136

Laboratory Demographics

  • CLIA Code: 05D2297832
  • Facility Name: WALGREENS 04136
  • Facility Address: 1919 FRUITRIDGE RD
    SACRAMENTO, CA
    ZIP 95822
  • Facility Phone: 916 457-5733
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BAO-CHAU H. TRAN
  • NPI Number: 1104831494
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2297832
LAB Type Pharmacy
Facility Name WALGREENS 04136
Street 1919 FRUITRIDGE RD
City SACRAMENTO
State CA
ZIP 95822
Phone 916 457-5733
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/23/2024
Certificate Expiration Date 1/22/2026
Facility Type Pharmacy
Lab Director BAO-CHAU H. TRAN

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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