05D2302153 CLIA NUMBER - WALGREENS 12574

Laboratory Demographics

  • CLIA Code: 05D2302153
  • Facility Name: WALGREENS 12574
  • Facility Address: 1219 N CEDAR AVE
    FRESNO, CA
    ZIP 93703
  • Facility Phone: 559 498-8283
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARIANA ESKANDAR
  • NPI Number: 1295740587
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302153
LAB Type Pharmacy
Facility Name WALGREENS 12574
Street 1219 N CEDAR AVE
City FRESNO
State CA
ZIP 93703
Phone 559 498-8283
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/4/2024
Certificate Expiration Date 4/3/2026
Facility Type Pharmacy
Lab Director MARIANA ESKANDAR

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