05D2301485 CLIA NUMBER - WALGREENS 11705

Laboratory Demographics

  • CLIA Code: 05D2301485
  • Facility Name: WALGREENS 11705
  • Facility Address: 3019 FLOYD AVE
    MODESTO, CA
    ZIP 95355
  • Facility Phone: 209 551-4867
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: GURSIMRAN KAUR GILL
  • NPI Number: 1437387347
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301485
LAB Type Pharmacy
Facility Name WALGREENS 11705
Street 3019 FLOYD AVE
City MODESTO
State CA
ZIP 95355
Phone 209 551-4867
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/26/2024
Certificate Expiration Date 3/25/2026
Facility Type Pharmacy
Lab Director GURSIMRAN KAUR GILL

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