05D2307380 CLIA NUMBER - WALGREENS 11877

Laboratory Demographics

  • CLIA Code: 05D2307380
  • Facility Name: WALGREENS 11877
  • Facility Address: 4771 W ASHLAN AVE
    FRESNO, CA
    ZIP 93722
  • Facility Phone: 559 274-0559
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: RAMANDEEP S. DHALIWAL
  • NPI Number: 1811220411
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307380
LAB Type Pharmacy
Facility Name WALGREENS 11877
Street 4771 W ASHLAN AVE
City FRESNO
State CA
ZIP 93722
Phone 559 274-0559
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/8/2024
Certificate Expiration Date 7/7/2026
Facility Type Pharmacy
Lab Director RAMANDEEP S. DHALIWAL

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