05D2298000 CLIA NUMBER - WALGREENS 04997

Laboratory Demographics

  • CLIA Code: 05D2298000
  • Facility Name: WALGREENS 04997
  • Facility Address: 226 RESERVATION RD
    MARINA, CA
    ZIP 93933
  • Facility Phone: 831 384-4700
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: THU T. TRAN
  • NPI Number: 1982619268
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2298000
LAB Type Pharmacy
Facility Name WALGREENS 04997
Street 226 RESERVATION RD
City MARINA
State CA
ZIP 93933
Phone 831 384-4700
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 1/25/2024
Certificate Expiration Date 1/24/2026
Facility Type Pharmacy
Lab Director THU T. TRAN

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