05D2302158 CLIA NUMBER - WALGREENS 12707

Laboratory Demographics

  • CLIA Code: 05D2302158
  • Facility Name: WALGREENS 12707
  • Facility Address: 4172 N 1ST ST
    FRESNO, CA
    ZIP 93726
  • Facility Phone: 559 243-0124
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ALI A. ESHAGHI
  • NPI Number: 1306851670
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2302158
LAB Type Pharmacy
Facility Name WALGREENS 12707
Street 4172 N 1ST ST
City FRESNO
State CA
ZIP 93726
Phone 559 243-0124
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 ALI A. ESHAGHI

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