05D2308164 CLIA NUMBER - WALGREENS 10421

Laboratory Demographics

  • CLIA Code: 05D2308164
  • Facility Name: WALGREENS 10421
  • Facility Address: 2875 MAIN ST
    SUSANVILLE, CA
    ZIP 96130
  • Facility Phone: 530 257-1020
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHARON HUANG
  • NPI Number: 1073683918
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2308164
LAB Type Pharmacy
Facility Name WALGREENS 10421
Street 2875 MAIN ST
City SUSANVILLE
State CA
ZIP 96130
Phone 530 257-1020
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/23/2024
Certificate Expiration Date 7/22/2026
Facility Type Pharmacy
Lab Director SHARON HUANG

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