05D2304190 CLIA NUMBER - WALGREENS 05500

Laboratory Demographics

  • CLIA Code: 05D2304190
  • Facility Name: WALGREENS 05500
  • Facility Address: 4331 ANTELOPE RD
    SACRAMENTO, CA
    ZIP 95843
  • Facility Phone: 916 722-3304
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LANA ALAZZAWI
  • NPI Number: 1104831486
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2304190
LAB Type Pharmacy
Facility Name WALGREENS 05500
Street 4331 ANTELOPE RD
City SACRAMENTO
State CA
ZIP 95843
Phone 916 722-3304
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/8/2024
Certificate Expiration Date 5/7/2026
Facility Type Pharmacy
Lab Director LANA ALAZZAWI

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This page was last updated on: 6/4/2025