05D2302018 CLIA NUMBER - WALGREENS #06613

Laboratory Demographics

  • CLIA Code: 05D2302018
  • Facility Name: WALGREENS #06613
  • Facility Address: 1401 BROADWAY
    SACRAMENTO, CA
    ZIP 95818
  • Facility Phone: 916 399-0650
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: TANYA V. LE
  • NPI Number: 1679742308
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302018
LAB Type Pharmacy
Facility Name WALGREENS #06613
Street 1401 BROADWAY
City SACRAMENTO
State CA
ZIP 95818
Phone 916 399-0650
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 TANYA V. LE

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