05D2302022 CLIA NUMBER - WALGREENS 12282

Laboratory Demographics

  • CLIA Code: 05D2302022
  • Facility Name: WALGREENS 12282
  • Facility Address: 2589 JENSEN AVE
    SANGER, CA
    ZIP 93657
  • Facility Phone: 559 875-4061
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: KHUONG DOA
  • NPI Number: 1447481619
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302022
LAB Type Pharmacy
Facility Name WALGREENS 12282
Street 2589 JENSEN AVE
City SANGER
State CA
ZIP 93657
Phone 559 875-4061
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 KHUONG DOA

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