05D2302037 CLIA NUMBER - WALGREENS 07653

Laboratory Demographics

  • CLIA Code: 05D2302037
  • Facility Name: WALGREENS 07653
  • Facility Address: 1145 S MAIN ST
    RED BLUFF, CA
    ZIP 96080
  • Facility Phone: 530 528-0478
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHAWNA M. ROUSH
  • NPI Number: 1982619995
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302037
LAB Type Pharmacy
Facility Name WALGREENS 07653
Street 1145 S MAIN ST
City RED BLUFF
State CA
ZIP 96080
Phone 530 528-0478
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 SHAWNA M. ROUSH

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This page was last updated on: 6/4/2025