05D2299588 CLIA NUMBER - WALGREENS 06355

Laboratory Demographics

  • CLIA Code: 05D2299588
  • Facility Name: WALGREENS 06355
  • Facility Address: 4201 DALE RD
    MODESTO, CA
    ZIP 95356
  • Facility Phone: 209 545-5687
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HAMZA ZIADEH
  • NPI Number: 1356356646
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299588
LAB Type Pharmacy
Facility Name WALGREENS 06355
Street 4201 DALE RD
City MODESTO
State CA
ZIP 95356
Phone 209 545-5687
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 HAMZA ZIADEH

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