05D2307300 CLIA NUMBER - WALGREENS 09102

Laboratory Demographics

  • CLIA Code: 05D2307300
  • Facility Name: WALGREENS 09102
  • Facility Address: 2271 BALFOUR RD
    BRENTWOOD, CA
    ZIP 94513
  • Facility Phone: 925 626-3491
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LIDIA N. GERGES
  • NPI Number: 1629254446
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307300
LAB Type Pharmacy
Facility Name WALGREENS 09102
Street 2271 BALFOUR RD
City BRENTWOOD
State CA
ZIP 94513
Phone 925 626-3491
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/5/2024
Certificate Expiration Date 7/4/2026
Facility Type Pharmacy
Lab Director LIDIA N. GERGES

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