CLIA lab
CLIA 05D2306742: Walgreens 04625
San Rafael, CA. Certificate and address details from the CMS Provider of Services file for clinical laboratories.
CLIA number 05D2306742 belongs to Walgreens 04625 in San Rafael, CA.
Certificate of Waiver, effective June 24, 2026, expires June 23, 2028.
Active in the CMS Provider of Services file posted October 16, 2026.
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
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Certificate
- Certificate type
- Certificate of Waiver
- Certificate effective
- June 24, 2026
- Certificate expiration
- June 23, 2028
- Status in the CMS file
- Active (termination code 00)
- Original participation date
- June 24, 2024
- Facility type
- Pharmacy
- Ownership (control type)
- Proprietary
- Lab classification
- CLIA laboratory
Source: CMS Provider of Services File, Clinical Laboratories (CLIA), as of October 16, 2026. Publisher page
Lab and contact
- CLIA number
- 05D2306742
- Lab name
- Walgreens 04625
- Address
- 830 3rd St, San Rafael, CA 94901
- Phone
- (415) 455-9919
- Fax
- (415) 455-4532
Annual test volume the lab reported
- Waived tests
- 12,775
Volumes are what the lab reported to CMS on its CMS-116 application, as carried in the file.
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- Bayside MarinCertificate of Waiver, Comprehensive outpatient rehab facility05D2091514
- Brett V Curtis MDCertificate of Waiver, Physician office05D0872179
- Center Point IncCertificate for Provider-Performed Microscopy Procedures, Comprehensive outpatient rehab facility05D0886299
- Cortica Healthcare Inc MarinCertificate of Waiver, Physician office05D2274367
- David M Tully-Smith, MD, A Medical CorporationCertificate of Waiver, Physician office05D1097391
- Evia Diagnostics Marin LLCCertificate of Waiver, Other05D2273473
- Health Diagnostics of California LLCCertificate of Waiver, Other05D2094888
- Heartwood House LLCCertificate of Waiver, Other05D2220049
Related
Questions
What is the CLIA number for Walgreens 04625 in San Rafael?
05D2306742, per the CMS Provider of Services file posted October 16, 2026.
What CLIA certificate does Walgreens 04625 hold?
A Certificate of Waiver, according to the CMS file.
When does CLIA 05D2306742 expire?
The CMS file lists June 23, 2028 as the certificate expiration date; the certificate took effect June 24, 2026.