05D2307098 CLIA NUMBER - WALGREENS 09525

Laboratory Demographics

  • CLIA Code: 05D2307098
  • Facility Name: WALGREENS 09525
  • Facility Address: 308 E PERKINS ST
    UKIAH, CA
    ZIP 95482
  • Facility Phone: 707 462-1265
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: ANTHONY Q. TRIEU
  • NPI Number: 1093899049
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307098
LAB Type Pharmacy
Facility Name WALGREENS 09525
Street 308 E PERKINS ST
City UKIAH
State CA
ZIP 95482
Phone 707 462-1265
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/1/2024
Certificate Expiration Date 6/30/2026
Facility Type Pharmacy
Lab Director ANTHONY Q. TRIEU

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