05D2301500 CLIA NUMBER - WALGREENS 11261

Laboratory Demographics

  • CLIA Code: 05D2301500
  • Facility Name: WALGREENS 11261
  • Facility Address: 520 PALMETTO AVE
    PACIFICA, CA
    ZIP 94044
  • Facility Phone: 650 355-9901
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: BARRY TSE
  • NPI Number: 1134359557
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2301500
LAB Type Pharmacy
Facility Name WALGREENS 11261
Street 520 PALMETTO AVE
City PACIFICA
State CA
ZIP 94044
Phone 650 355-9901
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 BARRY TSE

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