05D2306742 CLIA NUMBER - WALGREENS 04625

Laboratory Demographics

  • CLIA Code: 05D2306742
  • Facility Name: WALGREENS 04625
  • Facility Address: 830 3RD ST
    SAN RAFAEL, CA
    ZIP 94901
  • Facility Phone: 415 455-9919
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: YUMI FLORES
  • NPI Number: 1205841574
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2306742
LAB Type Pharmacy
Facility Name WALGREENS 04625
Street 830 3RD ST
City SAN RAFAEL
State CA
ZIP 94901
Phone 415 455-9919
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 6/24/2024
Certificate Expiration Date 6/23/2026
Facility Type Pharmacy
Lab Director YUMI FLORES

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