05D2297862 CLIA NUMBER - WALGREENS 04614

Laboratory Demographics

  • CLIA Code: 05D2297862
  • Facility Name: WALGREENS 04614
  • Facility Address: 2801 ADELINE ST
    BERKELEY, CA
    ZIP 94703
  • Facility Phone: 510 981-8392
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: IRIS G. PAW
  • NPI Number: 1558376830
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2297862
LAB Type Pharmacy
Facility Name WALGREENS 04614
Street 2801 ADELINE ST
City BERKELEY
State CA
ZIP 94703
Phone 510 981-8392
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 IRIS G. PAW

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