05D2301649 CLIA NUMBER - WALGREENS 12525

Laboratory Demographics

  • CLIA Code: 05D2301649
  • Facility Name: WALGREENS 12525
  • Facility Address: 700 TWELVE BRIDGES DR
    LINCOLN, CA
    ZIP 95648
  • Facility Phone: 916 408-0176
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JOSHUA K. MILES
  • NPI Number: 1770887614
  • Taxonomy: 333600000X - Pharmacy

Map and Directions

Get Directions

CLIA Record

Field Name Field Value
CLIA Number 05D2301649
LAB Type Pharmacy
Facility Name WALGREENS 12525
Street 700 TWELVE BRIDGES DR
City LINCOLN
State CA
ZIP 95648
Phone 916 408-0176
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/28/2024
Certificate Expiration Date 3/27/2026
Facility Type Pharmacy
Lab Director JOSHUA K. MILES

Download Record

Download this CLIA record record in Text format: Export

Download this CLIA record record in Excel (CSV) format: Export

Download this CLIA record record in XML format: Export

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