05D2307479 CLIA NUMBER - WALGREENS 15246

Laboratory Demographics

  • CLIA Code: 05D2307479
  • Facility Name: WALGREENS 15246
  • Facility Address: 2140 EL CAMINO REAL
    SANTA CLARA, CA
    ZIP 95050
  • Facility Phone: 408 246-1054
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: LYDIA CHEN
  • NPI Number: 1780699058
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2307479
LAB Type Pharmacy
Facility Name WALGREENS 15246
Street 2140 EL CAMINO REAL
City SANTA CLARA
State CA
ZIP 95050
Phone 408 246-1054
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/9/2024
Certificate Expiration Date 7/8/2026
Facility Type Pharmacy
Lab Director LYDIA CHEN

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