05D2303214 CLIA NUMBER - WALGREENS 06453

Laboratory Demographics

  • CLIA Code: 05D2303214
  • Facility Name: WALGREENS 06453
  • Facility Address: 1300 W YOSEMITE AVE
    MADERA, CA
    ZIP 93637
  • Facility Phone: 559 673-8172
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ELVIRA C. NEMENZO
  • NPI Number: 1174538458
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303214
LAB Type Pharmacy
Facility Name WALGREENS 06453
Street 1300 W YOSEMITE AVE
City MADERA
State CA
ZIP 93637
Phone 559 673-8172
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/22/2024
Certificate Expiration Date 4/21/2026
Facility Type Pharmacy
Lab Director ELVIRA C. NEMENZO

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