05D2062513 CLIA NUMBER - WALGREENS #05348

Laboratory Demographics

  • CLIA Code: 05D2062513
  • Facility Name: WALGREENS #05348
  • Facility Address: 34503 YUCAIPA BLVD
    YUCAIPA, CA
    ZIP 92399
  • Facility Phone: 909 790-7464
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: FADY DAOUD
  • NPI Number: 1124033402
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2062513
LAB Type Pharmacy
Facility Name WALGREENS #05348
Street 34503 YUCAIPA BLVD
City YUCAIPA
State CA
ZIP 92399
Phone 909 790-7464
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 7/26/2024
Certificate Expiration Date 7/25/2026
Facility Type Pharmacy
Lab Director FADY DAOUD

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