05D2062262 CLIA NUMBER - WALGREENS # 12143

Laboratory Demographics

  • CLIA Code: 05D2062262
  • Facility Name: WALGREENS # 12143
  • Facility Address: 5504 BALBOA AVE.
    SAN DIEGO, CA
    ZIP 92111
  • Facility Phone: 858 495-9155
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: CHERISH J. APPLIING, PIC
  • NPI Number: 1780849588
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2062262
LAB Type Pharmacy
Facility Name WALGREENS # 12143
Street 5504 BALBOA AVE.
City SAN DIEGO
State CA
ZIP 92111
Phone 858 495-9155
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/5/2025
Certificate Expiration Date 5/4/2027
Facility Type Pharmacy
Lab Director CHERISH J. APPLIING, PIC

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