05D2307271 CLIA NUMBER - WALGREENS 04681

Laboratory Demographics

  • CLIA Code: 05D2307271
  • Facility Name: WALGREENS 04681
  • Facility Address: 1424 BROADWAY
    EUREKA, CA
    ZIP 95501
  • Facility Phone: 707 441-1900
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LAITH H. ALSUDANY
  • NPI Number: 1215942594
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307271
LAB Type Pharmacy
Facility Name WALGREENS 04681
Street 1424 BROADWAY
City EUREKA
State CA
ZIP 95501
Phone 707 441-1900
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 LAITH H. ALSUDANY

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