05D2306112 CLIA NUMBER - WALGREENS 02366

Laboratory Demographics

  • CLIA Code: 05D2306112
  • Facility Name: WALGREENS 02366
  • Facility Address: 3860 DECOTO RD
    FREMONT, CA
    ZIP 94555
  • Facility Phone: 510 793-9798
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MELVIN J. QUINDOY
  • NPI Number: 1114932498
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2306112
LAB Type Pharmacy
Facility Name WALGREENS 02366
Street 3860 DECOTO RD
City FREMONT
State CA
ZIP 94555
Phone 510 793-9798
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/11/2024
Certificate Expiration Date 6/10/2026
Facility Type Pharmacy
Lab Director MELVIN J. QUINDOY

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