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05D2299600 CLIA NUMBER - WALGREENS 02786

Laboratory Demographics

CLIA Number: 05D2299600

Facility Name: WALGREENS 02786

Facility Address:
14100 BLOSSOM HILL RD
LOS GATOS, CA
ZIP 95032
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Facility Phone Number: 408 356-1152

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1164437430

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

CLIA Record

Field Name Field Value
CLIA Number 05D2299600
LAB Type Pharmacy
Facility Name WALGREENS 02786
Street 14100 BLOSSOM HILL RD
City LOS GATOS
State CA
ZIP 95032
Phone 408 356-1152
CertificateType 4
CertificateEffectiveDate 2/22/2024
CertificateExpirationDate 2/21/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024