05D2306361 CLIA NUMBER - WALGREENS 02957

Laboratory Demographics

  • CLIA Code: 05D2306361
  • Facility Name: WALGREENS 02957
  • Facility Address: 1660 WINCHESTER BLVD
    CAMPBELL, CA
    ZIP 95008
  • Facility Phone: 408 378-7916
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: MARITA C. WILCOX
  • NPI Number: 1073528352
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2306361
LAB Type Pharmacy
Facility Name WALGREENS 02957
Street 1660 WINCHESTER BLVD
City CAMPBELL
State CA
ZIP 95008
Phone 408 378-7916
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/17/2024
Certificate Expiration Date 6/16/2026
Facility Type Pharmacy
Lab Director MARITA C. WILCOX

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