05D2301253 CLIA NUMBER - WALGREENS 07079

Laboratory Demographics

  • CLIA Code: 05D2301253
  • Facility Name: WALGREENS 07079
  • Facility Address: 1615 MERIDIAN AVE
    SAN JOSE, CA
    ZIP 95125
  • Facility Phone: 408 978-5393
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: HARJIT BAINS
  • NPI Number: 1578578803
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301253
LAB Type Pharmacy
Facility Name WALGREENS 07079
Street 1615 MERIDIAN AVE
City SAN JOSE
State CA
ZIP 95125
Phone 408 978-5393
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/22/2024
Certificate Expiration Date 3/21/2026
Facility Type Pharmacy
Lab Director HARJIT BAINS

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This page was last updated on: 6/4/2025