05D2298528 CLIA NUMBER - WALGREENS 03445

Laboratory Demographics

  • CLIA Code: 05D2298528
  • Facility Name: WALGREENS 03445
  • Facility Address: 2779 S WHITE RD
    SAN JOSE, CA
    ZIP 95148
  • Facility Phone: 408 528-9349
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VICTOR CHANGCOCO
  • NPI Number: 1205841533
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2298528
LAB Type Pharmacy
Facility Name WALGREENS 03445
Street 2779 S WHITE RD
City SAN JOSE
State CA
ZIP 95148
Phone 408 528-9349
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/2/2024
Certificate Expiration Date 2/1/2026
Facility Type Pharmacy
Lab Director VICTOR CHANGCOCO

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