05D2299835 CLIA NUMBER - WALGREENS 10631

Laboratory Demographics

  • CLIA Code: 05D2299835
  • Facility Name: WALGREENS 10631
  • Facility Address: 14780 S HARLAN RD
    LATHROP, CA
    ZIP 95330
  • Facility Phone: 209 858-2801
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMANDA MARCHETTI
  • NPI Number: 1306033865
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2299835
LAB Type Pharmacy
Facility Name WALGREENS 10631
Street 14780 S HARLAN RD
City LATHROP
State CA
ZIP 95330
Phone 209 858-2801
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 2/27/2024
Certificate Expiration Date 2/26/2026
Facility Type Pharmacy
Lab Director AMANDA MARCHETTI

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