05D2062597 CLIA NUMBER - WALGREENS #09685

Laboratory Demographics

  • CLIA Code: 05D2062597
  • Facility Name: WALGREENS #09685
  • Facility Address: 2400 N. SEPULVEDA BLVD.
    MANHATTAN BEACH, CA
    ZIP 90266
  • Facility Phone: 424 241-1950
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: SHEREIF SORIAL
  • NPI Number: 1164747721
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 05D2062597
LAB Type Pharmacy
Facility Name WALGREENS #09685
Street 2400 N. SEPULVEDA BLVD.
City MANHATTAN BEACH
State CA
ZIP 90266
Phone 424 241-1950
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 SHEREIF SORIAL

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This page was last updated on: 6/4/2025