05D2301189 CLIA NUMBER - WALGREENS 16058

Laboratory Demographics

  • CLIA Code: 05D2301189
  • Facility Name: WALGREENS 16058
  • Facility Address: 1492 BLUE OAKS BLVD
    ROSEVILLE, CA
    ZIP 95747
  • Facility Phone: 916 945-3896
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAJESH H. WADHAVA
  • NPI Number: 1831593342
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301189
LAB Type Pharmacy
Facility Name WALGREENS 16058
Street 1492 BLUE OAKS BLVD
City ROSEVILLE
State CA
ZIP 95747
Phone 916 945-3896
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/21/2024
Certificate Expiration Date 3/20/2026
Facility Type Pharmacy
Lab Director RAJESH H. WADHAVA

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