05D2302027 CLIA NUMBER - WALGREENS 07274

Laboratory Demographics

  • CLIA Code: 05D2302027
  • Facility Name: WALGREENS 07274
  • Facility Address: 1456 136TH AVE
    SAN LEANDRO, CA
    ZIP 94578
  • Facility Phone: 510 618-1504
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: AMIT MUJRAL
  • NPI Number: 1427065424
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302027
LAB Type Pharmacy
Facility Name WALGREENS 07274
Street 1456 136TH AVE
City SAN LEANDRO
State CA
ZIP 94578
Phone 510 618-1504
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 AMIT MUJRAL

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