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05D2301500 CLIA NUMBER - WALGREENS 11261

Laboratory Demographics

CLIA Number: 05D2301500

Facility Name: WALGREENS 11261

Facility Address:
520 PALMETTO AVE
PACIFICA, CA
ZIP 94044
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Facility Phone Number: 650 355-9901

Facility Type: Pharmacy

Certificate Type: Waiver
NPI Number: 1134359557

Taxonomy: 333600000X - Pharmacy
A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

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
CertificateType 4
CertificateEffectiveDate 3/26/2024
CertificateExpirationDate 3/25/2026
FacilityType Waiver

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This page was last updated on: 4/23/2024