05D2299449 CLIA NUMBER - WALGREENS 06418

Laboratory Demographics

  • CLIA Code: 05D2299449
  • Facility Name: WALGREENS 06418
  • Facility Address: 1360 E PACHECO BLVD
    LOS BANOS, CA
    ZIP 93635
  • Facility Phone: 209 826-2796
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KELVIN AUNG
  • NPI Number: 1629083910
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299449
LAB Type Pharmacy
Facility Name WALGREENS 06418
Street 1360 E PACHECO BLVD
City LOS BANOS
State CA
ZIP 93635
Phone 209 826-2796
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/21/2024
Certificate Expiration Date 2/20/2026
Facility Type Pharmacy
Lab Director KELVIN AUNG

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