05D2303411 CLIA NUMBER - WALGREENS 13948

Laboratory Demographics

  • CLIA Code: 05D2303411
  • Facility Name: WALGREENS 13948
  • Facility Address: 1905 W EL CAMINO REAL
    MOUNTAIN VIEW, CA
    ZIP 94040
  • Facility Phone: 650 967-3531
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAUREN P. MANNING
  • NPI Number: 1124392147
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303411
LAB Type Pharmacy
Facility Name WALGREENS 13948
Street 1905 W EL CAMINO REAL
City MOUNTAIN VIEW
State CA
ZIP 94040
Phone 650 967-3531
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/24/2024
Certificate Expiration Date 4/23/2026
Facility Type Pharmacy
Lab Director LAUREN P. MANNING

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