05D2307275 CLIA NUMBER - WALGREENS 02314

Laboratory Demographics

  • CLIA Code: 05D2307275
  • Facility Name: WALGREENS 02314
  • Facility Address: 1050 GILMAN ST
    BERKELEY, CA
    ZIP 94710
  • Facility Phone: 510 528-8274
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: JULITA C. AGWUMEZIE
  • NPI Number: 1982619250
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307275
LAB Type Pharmacy
Facility Name WALGREENS 02314
Street 1050 GILMAN ST
City BERKELEY
State CA
ZIP 94710
Phone 510 528-8274
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 JULITA C. AGWUMEZIE

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