05D2299579 CLIA NUMBER - WALGREENS 06214

Laboratory Demographics

  • CLIA Code: 05D2299579
  • Facility Name: WALGREENS 06214
  • Facility Address: 210 MOUNT HERMAN RD
    SCOTTS VALLEY, CA
    ZIP 95066
  • Facility Phone: 831 430-9113
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIAN ESSA
  • NPI Number: 1992710271
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299579
LAB Type Pharmacy
Facility Name WALGREENS 06214
Street 210 MOUNT HERMAN RD
City SCOTTS VALLEY
State CA
ZIP 95066
Phone 831 430-9113
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/22/2024
Certificate Expiration Date 2/21/2026
Facility Type Pharmacy
Lab Director MARIAN ESSA

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