05D2302016 CLIA NUMBER - WALGREENS 06612

Laboratory Demographics

  • CLIA Code: 05D2302016
  • Facility Name: WALGREENS 06612
  • Facility Address: 8400 ELK GROVE FLORIN RD
    ELK GROVE, CA
    ZIP 95624
  • Facility Phone: 916 525-3563
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHERYL L. MATSUMOTO
  • NPI Number: 1942215033
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302016
LAB Type Pharmacy
Facility Name WALGREENS 06612
Street 8400 ELK GROVE FLORIN RD
City ELK GROVE
State CA
ZIP 95624
Phone 916 525-3563
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/3/2024
Certificate Expiration Date 4/2/2026
Facility Type Pharmacy
Lab Director CHERYL L. MATSUMOTO

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