05D2303497 CLIA NUMBER - WALGREENS 10114

Laboratory Demographics

  • CLIA Code: 05D2303497
  • Facility Name: WALGREENS 10114
  • Facility Address: 3521 DEL PASO RD
    SACRAMENTO, CA
    ZIP 95835
  • Facility Phone: 916 515-1866
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JON K. IZUMI
  • NPI Number: 1629272794
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2303497
LAB Type Pharmacy
Facility Name WALGREENS 10114
Street 3521 DEL PASO RD
City SACRAMENTO
State CA
ZIP 95835
Phone 916 515-1866
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/25/2024
Certificate Expiration Date 4/24/2026
Facility Type Pharmacy
Lab Director JON K. IZUMI

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