05D2307250 CLIA NUMBER - WALGREENS 06658

Laboratory Demographics

  • CLIA Code: 05D2307250
  • Facility Name: WALGREENS 06658
  • Facility Address: 6325 FAIR OAKS BLVD
    CARMICHAEL, CA
    ZIP 95608
  • Facility Phone: 916 480-0979
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: VANG S. THAO
  • NPI Number: 1861407157
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307250
LAB Type Pharmacy
Facility Name WALGREENS 06658
Street 6325 FAIR OAKS BLVD
City CARMICHAEL
State CA
ZIP 95608
Phone 916 480-0979
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/3/2024
Certificate Expiration Date 7/2/2026
Facility Type Pharmacy
Lab Director VANG S. THAO

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